Racial disparities in surgical management and outcomes of acute limb ischemia in the United States

• DOI: 10.1016/j.sopen.2021.08.003
• Publication Date: 2021-09-10T06:22:40Z
• Authors: Matthew Gandjian; Sohail Sareh; Alykhan Premji; Ramsey Ugarte; Zachary Tran; Nina Bowens; Peyman Benharash
• Keywords: Limb ischemia; Critical limb ischemia

Although significant racial disparities in the surgical management of lower extremity critical limb threatening ischemia have been previously reported, data on acute are lacking. The 2012–2018 National Inpatient Sample was queried for all adult hospitalizations (N = 225,180). Hospital-specific observed-to-expected rates major amputation were tabulated. Multivariable logistic and linear models developed to assess impact race revascularization. Nonwhite associated with significantly increased odds overall (adjusted ratio: 1.16, 95% confidence interval 1.06–1.28) primary 1.34, 1.17–1.53) amputation, decreased revascularization ratio 0.79, 0.73–0.85), but in-hospital mortality 0.86, 0.74–0.99). nonwhite group incurred adjusted index hospitalization costs (β: +$4,810, 3,280-6,350), length stay + 1.09 days, 0.70–1.48), nonhome discharge 1.15, 1.06–1.26). Significant exist outcomes despite correction variations hospital practices other relevant patient characteristics. Whether etiology lies primarily patient, institution, or healthcare provider–specific factors has not yet determined. Further studies race-based warranted provide effective equitable care all.