The analysis looked specifically at patients who had been hospitalized for serious blood flow constriction problems in the leg or foot area, brought on by peripheral vascular disease, hardening of the arteries in the extremities or arterial hardening following prior bypass graft surgery (also in the lower leg or foot).
Nearly 351,000 of the patients ultimately underwent either surgery aimed at restoring blood flow to (revascularizing) the affected areas, or they had an amputation. A little less than a third faced amputation while two-thirds had a revascularization procedure.
An in-depth look at patient demographics revealed that race did appear to independently affect the likelihood of undergoing an amputation versus blood flow surgery, even after accounting for differences in insurance coverage or personal wealth.
The bottom line: Just being black meant a 78 percent greater chance for undergoing an amputation than non-black patients, the study found.
Other issues that seemed to play a slightly stronger role than race in determining whether a patient would undergo amputation was if the patient had gangrene when hospitalized or if the patient had already previously undergone blood flow restoration surgery.
So although black patients were more likely to be hospitalized with diabetes or chronic renal failure -- and were more likely to fall into an income bracket where Medicaid coverage kicked in -- being black appeared to influence a decision regarding amputation.
The authors further found that being wealthy didn't protect blacks from the amputation gap, which actually was widest in facilities located in higher income areas. What's more, blacks were most likely to face an amputation at facilities that were actually the best prepared and equipped to perform blood flow surgery.
Two experts not involved in the
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