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Race A Factor In Decision To Amputate A Leg?

Fri, 03/22/2013 - 9:27am
Chris Kaiser

Amputation for peripheral arterial disease was nearly twice as likely for blacks as for whites, despite access to good hospitals or high patient income.

In hospitals with the greatest capacity to perform revascularizations, blacks had a 98% increased odds of undergoing amputation for critical lower limb ischemia than whites, independent of all other variables (OR 1.98, 95% CI 1.83 to 2.24), according to Tyler S. Durazzo, MD, and colleagues at the Yale University School of Medicine.

In addition, both blacks and whites with higher incomes had a better chance of revascularization, but even in the wealthiest ZIP codes, blacks were disproportionately more likely to undergo an amputation (OR 2.45, 95% CI 2.27 to 2.65), they wrote in the study published online in JAMA Surgery.

Durazzo and colleagues performed a multiple logistic regression analysis to determine the contribution of each statistically significant variable on the surgical decision and found that "being black alone," independent of all other variables, increased the odds of receiving an amputation by 78% (OR 1.78, 95% CI 1.72 to 1.84).

Black and Hispanic patients both had greater odds of undergoing an amputation compared with whites, but Hispanics were less likely to undergo amputation compared with blacks (34% whites versus 48% Hispanics versus 56% blacks).

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