Variation in Utilization of Procedures for Treatment of Peripheral Arterial Disease

Tunis, Sean; Bass, Eric B; Klag, Michael J.; Steinberg, Earl P.

doi:10.1001/archinte.1993.00410080053008

Cited by 92 publications

(29 citation statements)

References 40 publications

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“…176,177 This may also explain why US blacks appear less likely to undergo endovascular as opposed to open surgical revascularization and are at increased risk of amputation. However, life-style, socio-economic status, levels of insurance cover and thus unmet health-care need may be equally important 176,[177][178][179][180][181][182][183][184][185][186][187] (Supplementary Table W5). A study from South Africa also indicated that non-whites tend to present with more advanced disease, are less likely to have reconstruction and more likely to have amputation.…”

Section: Secondary Preventionmentioning

confidence: 99%

Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management

et al. 2007

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The United Kingdom is a diverse society with 7.9% of the population from black and minority ethnic groups (BMEGs). The causes of the excess cardiovascular disease (CVD) and stroke morbidity and mortality in BMEGs are incompletely understood though socio-economic factors are important. However, the role of classical cardiovascular (CV) risk factors is clearly important despite the patterns of these risk factors varying significantly by ethnic group. Despite the major burden of CVD and stroke among BMEGs in the UK, the majority of the evidence on the management of such conditions has been based on predominantly white European populations. Moreover, the CV epidemiology of African Americans does not represent well the morbidity and mortality experience seen in black Africans and black Caribbeans, both in Britain and in their native African countries. In particular, atherosclerotic disease and coronary heart disease are still relatively rare in the latter groups. This is unlike the South Asian diaspora, who have prevalence rates of CVD in epidemic proportions both in the diaspora and on the subcontinent. As the BMEGs have been under-represented in research, a multitude of guidelines exists for the 'general population.' However, specific reference and recommendation on primary and secondary prevention guidelines in relation to ethnic groups is extremely limited. This document provides an overview of ethnicity and CVD in the United Kingdom, with management recommendations based on a roundtable discussion of a multidisciplinary ethnicity and CVD consensus group, all of whom have an academic interest and clinical practice in a multiethnic community.

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Section: Secondary Preventionmentioning

confidence: 99%

Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management

et al. 2007

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“…African-Americans with diabetes have higher prevalence and incidence of peripheral vascular disease than do non- [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] 45-64 65-74 75+ Age Group Hispanic whites (8,30). However, neither African-Americans or Hispanics have a higher prevalence of diabetic peripheral neuropathy compared with non-Hispanic whites (28,32).…”

Section: Percentagementioning

confidence: 99%

Variation in the Incidence and Proportion of Diabetes-Related Amputations in Minorities

et al. 1996

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Hispanics had proportionally more amputations associated with diabetes than did African-Americans or non-Hispanic whites. A significant excess incidence of both diabetes- and non-diabetes-related amputations and proportionally more proximal amputations were identified in African-Americans compared with Hispanics and non-Hispanic whites. A possible explanation could be the higher prevalence of peripheral vascular disease in African-Americans. Public health initiatives, which have been demonstrated to reduce the incidence of diabetes-related lower-extremity amputations, should be implemented, and additional work should focus on minority groups.

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“…[1][2][3][4][5][6][7] Compared with non-Hispanic whites, African Americans have between two to four times the likelihood of undergoing a major (above or below knee) amputation, and this disparity increases among the oldest of the old. 1 While African Americans accounted for about 12% of the US population in 1996, they accounted for approximately 25% of all nontraumatic amputations in that year.…”

mentioning

confidence: 99%

“…8 While it might be thought that the greater amputation risk for African Americans is due to a higher prevalence of diabetes, 9 racial disparities exist for both patients with and without diabetes and the nondiabetic racial disparity in amputation rates may even be larger. 2,3,6,10,11 There is a broad consensus that aggressive primary care and preventive interventions such as diabetes foot care programs can reduce amputation incidence, and that many amputations are preventable. [12][13][14][15][16] Given the significant recent attention to reducing racial disparities, combined with numerous quality improvement initiatives for patients with diabetes, it was of interest to document whether racial disparities in amputation rates have been reduced over the last two decades.…”

mentioning

confidence: 99%

A census-based analysis of racial disparities in lower extremity amputation rates in Northern Illinois, 1987-2004

Feinglass

Abadin²,

Thompson

et al. 2008

Journal of Vascular Surgery

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Racial disparities have remained remarkably constant, despite progress in reducing the overall major amputation rate in northern Illinois. Addressing these disparities will require that low income, medically complex patients at risk of limb loss receive timelier, high performance care, combined with community-based public health and preventive medicine interventions that address the social determinants of health.

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Variation in Utilization of Procedures for Treatment of Peripheral Arterial Disease

Abstract: Patient race is associated with differences in the frequency with which angioplasty, bypass surgery, and amputation are performed for peripheral arterial disease, and insurance status is associated with the likelihood of having amputation.

Cited by 92 publications

References 40 publications

Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management

Ethnicity and cardiovascular disease prevention in the United Kingdom: a practical approach to management

Variation in the Incidence and Proportion of Diabetes-Related Amputations in Minorities

A census-based analysis of racial disparities in lower extremity amputation rates in Northern Illinois, 1987-2004

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