title: The Impact of Race on Advanced Chronic Venous Insufficiency.
abstract: BACKGROUND
  The study aimed to determine the association between race and patient variables, hospital covariates, and outcomes in patients presenting with advanced chronic venous insufficiency.
  
  
  METHODS
  The National Inpatient Sample was queried to identify all Caucasian and African-American patients with a primary International Classification of Diseases, Ninth Revision (ICD-9) diagnosis code for venous stasis with ulceration (454.0), inflammation (454.1), or complications (454.2) from 1998 to 2011. CEAP scores were correlated with ICD-9 diagnosis. Demographics, CEAP classification, management, cost of care, length of stay (LOS), and inpatient mortality were compared between races. Statistical analysis was via descriptive statistics, Student's t-test, and the Fisher's exact test. Trend analysis was completed using the Mann-Kendall test.
  
  
  RESULTS
  A total of 20,648 patients were identified of which 85% were Caucasian and 15% were African-American. Debridement procedures had the highest costs at $6,096 followed by skin grafting at $4,089. There was an overall decrease in the number of ulcer debridements, vein stripping, and sclerotherapy procedures between 1998 and 2011 (P < 0.05) for both groups. However, African-American patients had significantly more ulcer debridements than their Caucasian counterparts.
  
  
  CONCLUSIONS
  African-American patients with a primary diagnosis of venous stasis present with more advanced venous disease at a younger age compared with their Caucasian counterparts. This is associated with increased ulcer debridement, deep vein thrombosis rates and hospital charges in the African-American cohort. There are no differences in sclerotherapy or skin grafting procedures, LOS or inpatient mortality between races.
authors.affiliation: Department of Surgery, Medical College of Wisconsin, Milwaukee, WI. Electronic address: andua@mcw.edu.
authors.forename: Anahita
authors.initials: A
authors.lastname: Dua
authors.affiliation: Department of Vascular Surgery, Southern Illinois University, Springfield, IL.
authors.forename: Sapan S
authors.initials: SS
authors.lastname: Desai
authors.affiliation: Department of Surgery, Johns Hopkins Vein Center, Johns Hopkins Medical Center, Baltimore, MD.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Heller
mesh_terms: D001741:Black or African American; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D016208:Databases, Factual; D003646:Debridement / Q000639:trends; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology / Q000639:trends; D017722:Hospital Charges / Q000639:trends; D017721:Hospital Costs / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015911:Sclerotherapy / Q000639:trends; D012720:Severity of Illness Index; D016038:Skin Transplantation / Q000639:trends; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014689:Venous Insufficiency / Q000175:diagnosis / Q000191:economics / Q000208:ethnology* / Q000628:therapy; D044465:White People