Racial disparity in amputation-free survival after infrainguinal bypass procedure

Contribution of socioeconomic status

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: To investigate amputation-free survival after infrainguinal bypass in African Americans and Hispanics compared with non-Hispanic whites and to determine the contribution of socioeconomic status to potential racial disparity. Design: This is a retrospective cohort study of subjects who underwent infrainguinal bypass due to critical limb ischemia from 1997 through 2004. The primary end point was major amputation or death, whichever occurred first. Neighborhood socioeconomic status obtained from the 2000 United States Census was used as a proxy for an individual's socioeconomic status. Results: There were 595 subjects (237 non-Hispanic whites, 205 African Americans, 153 Hispanics) in the study. Median amputation-free survival was 1.3, 3.3, and 3.2 yrs among Hispanics, African Americans, and non-Hispanic whites, respectively. Hazard ratio for amputation or death was 1.38 (95% confidence interval, 1.02-1.87) in Hispanics and 0.81 (95% confidence interval, 0.63-1.16) in African Americans compared with non-Hispanic whites after multivariable adjustment. For those residing in their homes, adjusting for socioeconomic status attenuated the hazard ratio in Hispanics to 1.08, explaining 78% of increased hazard. ConclusionS: There was no significant difference between African Americans and non-Hispanic whites in amputation-free survival after infrainguinal bypass. Hispanics were 1.4 times more likely to have amputation or death than non-Hispanic whites, which was largely explained by low socioeconomic status.

Original languageEnglish (US)
Pages (from-to)986-994
Number of pages9
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume88
Issue number12
DOIs
StatePublished - Dec 2009

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Amputation
Hispanic Americans
Social Class
African Americans
Confidence Intervals
Proxy
Censuses
Cohort Studies
Ischemia
Extremities
Retrospective Studies

Keywords

  • Minority health
  • Peripheral vascular diseases
  • Socioeconomic factors
  • Survival analysis

ASJC Scopus subject areas

  • Rehabilitation
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Medicine(all)

Cite this

@article{e9edd31286524ec9b210d47e4a786ec5,
title = "Racial disparity in amputation-free survival after infrainguinal bypass procedure: Contribution of socioeconomic status",
abstract = "Objective: To investigate amputation-free survival after infrainguinal bypass in African Americans and Hispanics compared with non-Hispanic whites and to determine the contribution of socioeconomic status to potential racial disparity. Design: This is a retrospective cohort study of subjects who underwent infrainguinal bypass due to critical limb ischemia from 1997 through 2004. The primary end point was major amputation or death, whichever occurred first. Neighborhood socioeconomic status obtained from the 2000 United States Census was used as a proxy for an individual's socioeconomic status. Results: There were 595 subjects (237 non-Hispanic whites, 205 African Americans, 153 Hispanics) in the study. Median amputation-free survival was 1.3, 3.3, and 3.2 yrs among Hispanics, African Americans, and non-Hispanic whites, respectively. Hazard ratio for amputation or death was 1.38 (95{\%} confidence interval, 1.02-1.87) in Hispanics and 0.81 (95{\%} confidence interval, 0.63-1.16) in African Americans compared with non-Hispanic whites after multivariable adjustment. For those residing in their homes, adjusting for socioeconomic status attenuated the hazard ratio in Hispanics to 1.08, explaining 78{\%} of increased hazard. ConclusionS: There was no significant difference between African Americans and non-Hispanic whites in amputation-free survival after infrainguinal bypass. Hispanics were 1.4 times more likely to have amputation or death than non-Hispanic whites, which was largely explained by low socioeconomic status.",
keywords = "Minority health, Peripheral vascular diseases, Socioeconomic factors, Survival analysis",
author = "Mooyeon Oh-Park and McGinn, {Aileen P.} and Lipsitz, {Evan C.} and Thomas, {Mark A.} and Joel Zonszein",
year = "2009",
month = "12",
doi = "10.1097/PHM.0b013e3181bc0ae4",
language = "English (US)",
volume = "88",
pages = "986--994",
journal = "American Journal of Physical Medicine and Rehabilitation",
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T1 - Racial disparity in amputation-free survival after infrainguinal bypass procedure

T2 - Contribution of socioeconomic status

AU - Oh-Park, Mooyeon

AU - McGinn, Aileen P.

AU - Lipsitz, Evan C.

AU - Thomas, Mark A.

AU - Zonszein, Joel

PY - 2009/12

Y1 - 2009/12

N2 - Objective: To investigate amputation-free survival after infrainguinal bypass in African Americans and Hispanics compared with non-Hispanic whites and to determine the contribution of socioeconomic status to potential racial disparity. Design: This is a retrospective cohort study of subjects who underwent infrainguinal bypass due to critical limb ischemia from 1997 through 2004. The primary end point was major amputation or death, whichever occurred first. Neighborhood socioeconomic status obtained from the 2000 United States Census was used as a proxy for an individual's socioeconomic status. Results: There were 595 subjects (237 non-Hispanic whites, 205 African Americans, 153 Hispanics) in the study. Median amputation-free survival was 1.3, 3.3, and 3.2 yrs among Hispanics, African Americans, and non-Hispanic whites, respectively. Hazard ratio for amputation or death was 1.38 (95% confidence interval, 1.02-1.87) in Hispanics and 0.81 (95% confidence interval, 0.63-1.16) in African Americans compared with non-Hispanic whites after multivariable adjustment. For those residing in their homes, adjusting for socioeconomic status attenuated the hazard ratio in Hispanics to 1.08, explaining 78% of increased hazard. ConclusionS: There was no significant difference between African Americans and non-Hispanic whites in amputation-free survival after infrainguinal bypass. Hispanics were 1.4 times more likely to have amputation or death than non-Hispanic whites, which was largely explained by low socioeconomic status.

AB - Objective: To investigate amputation-free survival after infrainguinal bypass in African Americans and Hispanics compared with non-Hispanic whites and to determine the contribution of socioeconomic status to potential racial disparity. Design: This is a retrospective cohort study of subjects who underwent infrainguinal bypass due to critical limb ischemia from 1997 through 2004. The primary end point was major amputation or death, whichever occurred first. Neighborhood socioeconomic status obtained from the 2000 United States Census was used as a proxy for an individual's socioeconomic status. Results: There were 595 subjects (237 non-Hispanic whites, 205 African Americans, 153 Hispanics) in the study. Median amputation-free survival was 1.3, 3.3, and 3.2 yrs among Hispanics, African Americans, and non-Hispanic whites, respectively. Hazard ratio for amputation or death was 1.38 (95% confidence interval, 1.02-1.87) in Hispanics and 0.81 (95% confidence interval, 0.63-1.16) in African Americans compared with non-Hispanic whites after multivariable adjustment. For those residing in their homes, adjusting for socioeconomic status attenuated the hazard ratio in Hispanics to 1.08, explaining 78% of increased hazard. ConclusionS: There was no significant difference between African Americans and non-Hispanic whites in amputation-free survival after infrainguinal bypass. Hispanics were 1.4 times more likely to have amputation or death than non-Hispanic whites, which was largely explained by low socioeconomic status.

KW - Minority health

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KW - Survival analysis

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