Disparities in Amputations in Minorities
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As a result of the impact of health disparities on the healthcare system such as their influence on arenas significant to healthcare distribution, including cost, quality, and access, identification and resolution of health disparities is a primary national agenda item. Resolution of disparities in amputation is an area of opportunity that warrants further consideration.
The purposes of our review are to highlight current data on disparities in amputation in minorities and to consider future goals related to an elimination of this disparity.
Studies on disparities in amputation were accessed using the following databases: PubMed, Cinahl, OVID/Medline, Embase, and Cochrane databases. In each database, a search of title/abstract was performed for the search terms “disparities and amputation,” “race and amputation,” and “diabetes and amputation.” Each search was limited by human and English language.
Where are we now? A disparity exists in both frequency and level of amputation in minorities both in the presence and absence of a diagnosis of diabetes.
Where do we need to go? A need exists for future research involving a more deliberate examination of the use of preventive screening for patients at high risk for amputation across medical settings.
How do we get there? Research in this area would benefit from funding, large-scale data collection, and physician exposure to education on high-risk patients and preventive screening opportunities.
KeywordsPeripheral Arterial Disease Black Race Lower Extremity Amputation Racial Health Disparity Patient Treatment File
- 2.Adams HP Jr, del Zoppo G, Alberts MJ, Bhatt DL, Brass L, Furlan A, Grubb RL, Higashida RT, Jauch EC, Kidwell C, Lyden PD, Morgenstern LB, Qureshi AI, Rosenwasser RH, Scott PA, Wijdicks EF. Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Stroke. 2007;38:1655–1711.Google Scholar
- 6.Brothers TE, Robison JG, Sutherland SE, Elliott BM. Racial differences in operation for peripheral vascular disease: results of a population-based study. Cardiovasc Surg. 1997;5:2631.Google Scholar
- 7.Burke GL, Evans GW, Riley WA, Sharrett AR, Howard G, Barnes RW, Rosamond W, Crow RS, Rautaharju PM, Heiss G. Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) Study. Stroke. 1995;26:386–391.PubMedGoogle Scholar
- 10.Collins TC, Johnson M, Henderson W, Khuri SF, Daley J. Lower extremity non traumatic amputation among veterans with peripheral arterial disease: is race an independent factor? Med Care. 2002;40:1106–1116.Google Scholar
- 32.Lavery LA, Ashry HR, van Houtum W, Pugh JA, Harkless LB, Basu S. Variation in the incidence and proportion of diabetes related amputations in minorities. Diabet Care. 1996;19:4854.Google Scholar
- 36.McDermott MM, Greenland P, Liu K, Guralnik JM, Celic L, Criqui MH, Chan C, Martin GJ, Schneider J, Pearce WH, Taylor LM, Clark E. The ankle brachial index is associated with leg function and physical activity: the Walking and Leg Circulation Study. Ann Intern Med. 2002;136:873–883.PubMedGoogle Scholar
- 51.Selby JV, Fireman BH, Lundstrom RJ, Swain BE, Truman AF, Wong CC, Froelicher ES, Barron HV, Hlatky MA. Variation among hospitals in coronary-angiography practices and outcomes after myocardial infarction in a large health maintenance organization. N Engl J Med. 1996;335:1888–1896.PubMedCrossRefGoogle Scholar