| Temporal Trends and Geographic Variation of Lower-Extremity Amputation in Patients With Peripheral Artery Disease: Results From U.S. Medicare 2000-2008. | |
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MedLine Citation:
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PMID: 23103040 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVES: We sought to characterize temporal trends, patient-specific factors, and geographic variation associated with amputation in patients with lower-extremity peripheral artery disease (LE PAD) during the study period. BACKGROUND: Amputation represents the end-stage failure for those with LE PAD, and little is known about the rates and geographic variation in the use of LE amputation. METHODS: By using data from the Centers for Medicare & Medicaid Services (CMS) from January 1, 2000, to December 31, 2008, we examined national patterns of LE amputation among patients age 65 years or more with PAD. Multivariable logistic regression was used to adjust regional results for other patient demographic and clinical factors. RESULTS: Among 2,730,742 older patients with identified PAD, the overall rate of LE amputation decreased from 7,258 per 100,000 patients with PAD to 5,790 per 100,000 (p < 0.001 for trend). Male sex, black race, diabetes mellitus, and renal disease were all independent predictors of LE amputation. The adjusted odds ratio of LE amputation per year between 2000 and 2008 was 0.95 (95% CI: 0.95-0.95, p < 0.001). CONCLUSIONS: From 2000 to 2008, LE amputation rates decreased significantly among patients with PAD. However, there remains significant patient and geographic variation in amputation rates across the United States. |
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Authors:
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W Schuyler Jones; Manesh R Patel; David Dai; Sumeet Subherwal; Judith Stafford; Sarah Calhoun; Eric D Peterson |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-10-12 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: - ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2012 Oct |
Date Detail:
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Created Date: 2012-10-29 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina; Division of Cardiology, Duke University Medical Center, Durham, North Carolina. Electronic address: schuyler.jones@dm.duke.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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