Peripheral Bypass Surgery and Amputation

摘要: Hypothesis This study tests whether age, sex, income, and racial differences predict rates of aortoiliac femorodistal bypass surgery above- below-knee amputation for residents northern Illinois from 1993 to 1997. Design A hospital discharge survey describing standardized procedure the odds undergoing vs procedures specified sociodemographic populations. Multiple logistic regression was used compare major controlling prevalence diabetes, gangrene, high-risk comorbid conditions, treatment at area teaching hospitals. Results Between 1997, 19,250 were performed during 18,603 admissions 105 The mean annual rate per 100,000 20.77; 24.26 4.70, respectively. Significantly higher (between 1.14 1.36) found low-income areas ZIP codes with large medium African American Severe comorbidity, especially gangrene (odds ratio, 12.9) predicted amputation, while a male sex procedures. Conclusions are consistent unmeasured income in severity atherosclerosis (or related risk factors such as smoking, diet, exercise), barriers timely primary care, or selective referral lower-income patients hospitals less vascular capacity. These findings imply particular need identify review quality care lower-extremity amputations.