Trends in hospital treatments for peripheral arterial disease in the <scp>U</scp>nited <scp>S</scp>tates and association between payer status and quality of care/outcomes, 2007–2011

Kim, Luke K.; Swaminathan, Rajesh V.; Minutello, Robert M.; Gade, Christina; Yang, Dixon; Charitakis, Konstantinos; Shah, Ashish; Kaple, Ryan; Bergman, Geoffrey; Singh, Harsimran; Wong, S. Chiu; Feldman, Dmitriy N.

doi:10.1002/ccd.26065

Cited by 24 publications

(19 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although insurance status has been shown to increase the likelihood of amputation in PAD in the United States,22, 33 socioeconomic deprivation is associated with lower extremity amputations in a nationalized health system like the United Kingdom 34. Studies from the VA system have shown better health outcomes for minorities with CAD, heart failure, and hospitalizations 35, 36, 37.…”

Section: Discussionmentioning

confidence: 99%

Race and Socioeconomic Status Independently Affect Risk of Major Amputation in Peripheral Artery Disease

Arya

Binney

Khakharia

et al. 2018

JAHA

171

117

View full text Add to dashboard Cite

BackgroundBlack race has been shown to be a risk factor for amputation in peripheral artery disease (PAD); however, race has been argued to be a marker for socioeconomic status (SES) rather than true disparity. The aim of this study is to study the impact of race and SES on amputation risk in PAD patients.Methods and ResultsPatients with incident PAD in the national Veterans Affairs Corporate Data Warehouse were identified from 2003 to 2014 (N=155 647). The exposures were race and SES (measured by median income in residential ZIP codes). The outcome was incident major amputation. Black veterans were significantly more likely to live in low‐SES neighborhoods and to present with advanced PAD. Black patients had a higher amputation risk in each SES stratum compared with white patients. In Cox models (adjusting for covariates), black race was associated with a 37% higher amputation risk compared with white race (hazard ratio: 1.37; 95% confidence interval, 1.30–1.45), whereas low SES was independently predictive of increased risk of amputation (hazard ratio: 1.12; 95% confidence interval, 1.06–1.17) and showed no evidence of interaction with race. In predicted amputation risk analysis, black race and low SES continued to be significant risk factors for amputation regardless of PAD presentation.ConclusionsBlack race significantly increases the risk of amputation within the same SES stratum compared with white race and has an independent effect on limb loss after controlling for comorbidities, severity of PAD at presentation, and use of medications.

show abstract

Section: Discussionmentioning

confidence: 99%

Race and Socioeconomic Status Independently Affect Risk of Major Amputation in Peripheral Artery Disease

Arya

Binney

Khakharia

et al. 2018

JAHA

171

117

View full text Add to dashboard Cite

show abstract

“…Prior research has suggested patients with Medicaid insurance often have significant comorbid conditions and present with advanced disease which may lead to increased complications following treatment. 15 Thus, there may be an inherent selection bias among providers to limit treatment among these patients.…”

Section: Discussionmentioning

confidence: 99%

Population-based assessment of racial/ethnic differences in utilization of radical cystectomy for patients diagnosed with bladder cancer

Williams

Huo

Kosarek

et al. 2017

Cancer Causes Control

View full text Add to dashboard Cite

Purpose Radical cystectomy is a surgical treatment for recurrent non-muscle invasive and muscle-invasive bladder cancer, however, many patients may not receive this treatment. Methods A total of 27,578 patients diagnosed with clinical stage I to IV bladder cancer from January 1, 2007 to December 31, 2013 were identified from the Surveillance, Epidemiology, and End Results (SEER) registry database. We used multivariable regression analyses to identify factors predicting use of radical cystectomy and pelvic lymph node dissection. Cox proportional hazards models were used to analyze survival outcomes. Results A total of 1,693 (6.1%) patients with bladder cancer underwent radical cystectomy. Most patients (92.4%) who underwent radical cystectomy also underwent pelvic lymph node dissection. When compared with white patients, non-Hispanic blacks were less likely to undergo a radical cystectomy (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.64–0.96, p = 0.019). Moreover, recent year of surgery 2013 vs. 2007 (OR 2.32, 95% CI 1.90–2.83, p < 0.001), greater percentage of college education ≥ 36.3% vs. <21.3% (OR 1.23, 95% CI 1.04–1.44, p =0.013), Midwest vs. West (OR 1.64, 95% CI 1.39–1.94, p<0.001) and more advanced clinical stage III vs. I (OR 29.1, 95% CI 23.9–35.3, p<0.001) was associated with increased use of radical cystectomy. Overall survival was improved for patients who underwent radical cystectomy compared with those who did not undergo a radical cystectomy (hazard ratio 0.88, 95% CI 0.80–0.97, p = 0.008). Conclusion There is significant underutilization of radical cystectomy in patients across all age groups diagnosed with bladder cancer, especially among older, non-Hispanic black patients.

show abstract

“…(1) Despite advances in medical management and transcatheter treatments, some patients still require surgical bypass. 400,000 coronary artery bypasses and 460,000 peripheral artery bypasses are performed each year in the U.S. (1,2) At least another 80,000 Americans receive arteriovenous fistulae or grafts for hemodialysis vascular access. (3,4) These procedures save lives or limbs.…”

Section: Introductionmentioning

confidence: 99%

Quickening: Translational design of resorbable synthetic vascular grafts

Stowell

Wang

2018

Biomaterials

View full text Add to dashboard Cite

Traditional tissue-engineered vascular grafts have yet to gain wide clinical use. The difficulty of scaling production of these cell- or biologic-based products has hindered commercialization. In situ tissue engineering bypasses such logistical challenges by using acellular resorbable scaffolds. Upon implant, the scaffolds become remodeled by host cells. This review describes the scientific and translational advantages of acellular, synthetic vascular grafts. It surveys in vivo results obtained with acellular synthetics over their fifty years of technological development. Finally, it discusses emerging principles, highlights strategic considerations for designers, and identifies questions needing additional research.

show abstract

Trends in hospital treatments for peripheral arterial disease in the United States and association between payer status and quality of care/outcomes, 2007–2011

Cited by 24 publications

References 24 publications

Race and Socioeconomic Status Independently Affect Risk of Major Amputation in Peripheral Artery Disease

Race and Socioeconomic Status Independently Affect Risk of Major Amputation in Peripheral Artery Disease

Population-based assessment of racial/ethnic differences in utilization of radical cystectomy for patients diagnosed with bladder cancer

Quickening: Translational design of resorbable synthetic vascular grafts

Contact Info

Product

Resources

About