Minorities With Severe Leg Blockages at Higher Risk of Amputation

THURSDAY Feb. 3, 2011 -- Minority patients suffering from severe arterial blockages in their lower limbs face a greater chance of amputation than white patients, new research suggests.

The finding held even after accounting for other potentially influential factors, such as patient income and insurance status. But the researchers added that it seemed to reflect upon the relatively lower socioeconomic status of minority patients, as well as the less well-equipped types of hospitals at which they tend to receive care.

"Minority patients tend to have more comorbidities -- including diabetes, peripheral artery disease (PAD) and renal failure -- that influence treatment options, as they are more likely to receive care at low-volume and potentially under-resourced hospitals," study senior author Dr Louis L. Nguyen said in a news release from the Society for Vascular Surgery. "These factors, independently and in combination, are associated with a greater likelihood of major amputation."

Nguyen, who works in the division of vascular and endovascular surgery and the Center for Surgery and Public Health at Brigham and Women's Hospital in Boston, reported the team's findings in the February issue of Vascular Surgery.

The current finding stems from a national review of nearly 960,000 cases involving lower extremity revascularization or major amputation between 2003 and 2007.

Information regarding instances of limb arterial blockage was collected from among this pool of patients, who were all aged 21 and older.

After dividing the patients into one of four income categories, the research team found that those in the bottom three income groups were between 11 percent and 34 percent more likely to undergo an amputation than those in the highest income group.

Native Americans were the most likely to fall into the lowest income bracket, followed by blacks and Hispanics.

Those who had private insurance tended to be in the higher income brackets, the study authors found, and seemed to face a lower risk for undergoing a major amputation.

Patients who sought care at a lower-volume hospital, which tend to have fewer specialists, had a 15 times higher risk for undergoing an amputation than patients attending the highest-volume hospitals.

More information

For the more on arterial blockage and treatment, visit VascularWeb.org.

Posted: February 2011


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