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Cited by 100Peripheral Artery Disease ManagementHealth disparities and outcomesVascular Procedures and Complications

The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.

Impact of race on the treatment for peripheral arterial occlusive disease

Open access
Huber, Thomas S., Wang, Jeffrey G., Wheeler, Kevin G., Cuddeback, John K., Dame, Douglas A., Ozaki, C.Keith, Flynn, Timothy C., Seeger, James M.·1999·Journal of Vascular Surgery
DOI 10.1016/s0741-5214(99)70068-6
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Abstract

Purpose The purpose of this study was to determine the impact of race on the treatment of peripheral artery occlusive disease (PAOD) and to examine the role of access to care and disease distribution on the observed racial disparity.Methods The study was performed as a retrospective analysis of hospital discharge abstracts from 1992 to 1995 in 202 non-federal, acute-care hospitals in the state of Florida. The subjects were patients older than 44 years of age who underwent major lower extremity amputation or revascularization (bypass grafting or angioplasty) for PAOD. The main outcome measures were incidence of intervention, incidence per demographic group, multivariate predictors of amputation versus revascularization, multivariate predictors of amputation versus revascularization among those patients with access to sophisticated care (hospital with arteriographic capabilities), and multivariate predictors of surgical bypass graft type (aortoiliac vs infrainguinal).Results A total of 51,819 procedures (9.1 per 10,000 population) were performed for PAOD during the study period and included 15,579 major lower extremity amputations (30.1%) and 36,240 revascularizations (69.9%). Although the incidence of a procedure for PAOD was comparable between African Americans and whites (9.0 vs 9.6 per 10, 000 demographic group), the incidence of amputation (5.0 vs 2.5 per 10,000 demographic group) was higher and the incidence of revascularization (4.0 vs 7.1 per 10,000 demographic group) was lower among African Americans. Furthermore, multivariate analysis results showed that African Americans (odds ratio, 3.79; 95% confidence interval [CI], 3.34 to 4.30) were significantly more likely than whites to undergo amputation as opposed to revascularization. The secondary multivariate analyses results revealed that African Americans (odds ratio, 2.29; 95% CI, 1.58 to 3. 33) were more likely to undergo amputation among those patients (n = 9193) who underwent arteriography during the procedural admission and to undergo infrainguinal bypass grafting (odds ratio, 2.00; 95% CI, 1.48 to 2.71) among those patients (n = 27,796) who underwent surgical bypass grafting.Conclusion There is a marked racial disparity in the treatment of patients with PAOD that may be caused in part by differences in the severity of disease or disease distribution.

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  • An analysis of ≈16,000 patients who underwent infrainguinal bypass found increased rates of early graft failure in Black Americans despite no difference in conduit use across groups.

    “One analysis of ≈16 000 patients who underwent infrainguinal bypass found increased rates of early graft failure in Black Americans despite no difference in conduit use across groups.109”

    From Racial and Ethnic Disparities in Peripheral Artery Disease (2021) · cites this paper as [109]

    The Results (page unavailable) analyze 27,796 surgical-bypass patients and report that African Americans were more likely than whites to undergo infrainguinal rather than aortoiliac bypass. The passages found for early graft failure, conduit use, and an approximately 16,000-patient infrainguinal cohort do not address those claims. A difference in procedure type does not establish a difference in graft failure. (LLM, conf=0.77)

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Research works printed but not linked: 1

  1. Tunis, 1993, Variation in utilization of procedures for treatment of peripheral arterial disease, Arch Intern Med, 153, 991, 10.1001/archinte.1993.00410080053008 · DOI

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Metadata

Authors
Huber, T. S., Wang, J. G., Wheeler, K. G., Cuddeback, J. K., Dame, D. A., Ozaki, C. K., Flynn, T. C., & Seeger, J. M.
Affiliations
University of Florida Health (US)
ORCID
Venue
Journal of Vascular Surgery
Publisher
Elsevier BV
Published
1999-09
Volume
30
Issue
3
Pages
417-426
ISSN
0741-5214 (ISSN-L)
DOI
10.1016/s0741-5214(99)70068-6
OpenAlex
W2002931365
Semantic Scholar
0bd6a85a2853c670b95b535c889e18f772497b74
Cited by
100
References
41
Citations by year
2026: 1 · 2025: 1 · 2024: 5 · 2023: 5 · 2022: 8 · 2021: 2 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 5 · 2015: 2 · 2014: 4 · 2013: 4 · 2012: 1
FWCI
1.04
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Vascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vascular Procedures and Complications
Keywords
peripheral arterial disease, racial disparities, African Americans, lower limb amputation, revascularization, bypass grafting, infrainguinal bypass, aortoiliac bypass, arteriography, health care access, disease distribution, hospital discharge data, Florida hospitals, health care utilization, older adults, length of hospital stay
MeSH terms
Age Factors, Aged, Aged, 80 and over, Amputation, Surgical, Angiography, Aorta, Arterial Occlusive Diseases, Black or African American, Female, Florida, Forecasting, Health Services Accessibility, Hospitals, General, Humans, Iliac Artery, Inguinal Canal, Male, Middle Aged, Retrospective Studies, Sex Factors, Vascular Surgical Procedures, Incidence, Multivariate Analysis, Confidence Intervals, Odds Ratio, Peripheral Vascular Diseases, Outcome Assessment, Health Care, Angioplasty, Black People, White People

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