IntroductionWhile studies have documented racial and ethnic disparities in amputation rates for patients with peripheral artery disease (PAD), the importance of specific factors has not been quantified. This research seeks to provide such evidence and to quantify how much of the difference reflects observable versus unexplained factors.MethodsThis study used the nationally representative HCUP inpatient database from 2006 to 2013 for patients with a primary diagnosis of PAD who were either Caucasian, African-American, or Hispanic. Multivariable logistic regression models were estimated to identify the determinants of amputation rates.ResultsMultivariable results revealed that African-Americans and Hispanics are approximately twice as likely to be amputated as are Caucasians. Observed factors in the models collectively account for 51 to 55 % of the disparities for African-Americans and 64 to 69 % for Hispanics. The results suggest that African-Americans and Hispanics have less access to care, because they are being admitted when sicker and more likely on an emergent basis.ConclusionsRacial and ethnic disparities in amputation rates are substantial, with disease severity and hospital admission source being key factors.Electronic supplementary materialThe online version of this article (doi:10.1007/s40615-016-0261-9) contains supplementary material, which is available to authorized users.

Background In this study, we examine the relationship between level of education of patients and five year mortality following major lower extremity amputation. Methods We retrospectively reviewed the records of all patients who underwent above- or below-knee amputation at the Nashville VA by the vascular surgery service between January 2000 and August 2006. Formal level of education of the study patients was recorded. Outcomes were compared between those patients who had completed high school and those who had not. Bivariate analysis using chi-square and student's t-test, and multivariable logistic regression were performed. Results Five year mortality for patients who completed high school was lower than those who had not completed high school (62.6% vs. 84.3%; p = 0.001), even after adjusting for important clinical factors (Odds Ratio of death = 0.377, 95% CI 0.164 – 0.868 p=0.022). Conclusions Patients with less education have increased long term mortality following lower extremity amputation.

No abstract

No abstract

No abstract