Document Detail


Racial and ethnic differences in patterns of treatment for acute peripheral arterial disease in the United States, 1998-2006.
MedLine Citation:
PMID:  20080006     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Prior studies have documented racial and ethnic disparities in rates of amputations for peripheral arterial disease (PAD) in the United States. We analyze whether there are underlying differences in the types of treatment provided to patients who are acutely hospitalized for PAD. METHODS: The 1998-2006 Nationwide Inpatient Sample was used to examine patterns of treatment. We considered a hospitalization an acute admission for PAD if (1) the primary diagnosis was PAD, and (2) the patient was admitted urgently or emergently or through an emergency department. Vascular interventions were designated as open bypass, endovascular intervention, or major amputation, defined as disarticulation at the ankle or higher amputation. RESULTS: From 1998 through 2006, the likelihood of an endovascular procedure being performed during an acute hospitalization for PAD increased from 11.5% to 35.3%, and open vascular procedures decreased from 34.9% to 25.4%. The likelihood of a major amputation during an acute hospitalization for PAD decreased from 29.7% to 20.3%. Black and Hispanic patients were more likely than white patients to undergo amputation and were less likely to have an endovascular or open revascularization. CONCLUSION: Use of endovascular procedures has increased and use of open vascular bypass has decreased in the inpatient treatment of acute PAD. Although the overall likelihood of amputation has decreased, racial and ethnic differences persist, with black and Hispanic patients experiencing a higher likelihood of amputation.
Authors:
Vincent L Rowe; Fred A Weaver; John S Lane; David A Etzioni
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-01-15
Journal Detail:
Title:  Journal of vascular surgery : official publication, the Society for Vascular Surgery [and] International Society for Cardiovascular Surgery, North American Chapter     Volume:  51     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-04-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  21S-26S     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
CardioVascular Thoracic Institute, Division of Vascular and Endovascular Surgery, Department of Surgery, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, USA. vrowe@surgery.usc.edu
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MeSH Terms
Descriptor/Qualifier:
African Americans / statistics & numerical data
Aged
Aged, 80 and over
Amputation / trends
Continental Population Groups / statistics & numerical data*
Databases as Topic
Ethnic Groups / statistics & numerical data*
European Continental Ancestry Group / statistics & numerical data
Female
Healthcare Disparities / trends*
Hispanic Americans / statistics & numerical data
Hospitalization / trends
Humans
Likelihood Functions
Limb Salvage / trends
Logistic Models
Male
Middle Aged
Outcome and Process Assessment (Health Care) / trends*
Peripheral Vascular Diseases / ethnology,  surgery*
Physician's Practice Patterns / trends*
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
United States / epidemiology
Vascular Surgical Procedures / adverse effects,  trends*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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