African-Americans in areas with low rates of diagnosed PAD at higher risk of amputation
At the Society for Vascular Surgery’s online Scientific Session 8, Mark Eid, MD presented a talk called, “Racial and regional disparities in the prevalence of peripheral artery disease and diabetes and amputation rates among Medicare patients.”
The research suggested that African-American patients living in areas where the diagnosed rates of peripheral artery disease (PAD) and diabetes are lowest have higher rates of non-traumatic amputation.
The study was based on a cohort of 10.5 million patients based on data from CMS from 2007-2016, who were concurrently diagnosed as having both PAD and diabetes. Analyzing this cohort, they found a non-traumatic amputation rate that varied more than 6-fold across the US.
The average amputation rate for this cohort of patients with PAD and diabetes was 25.9 per 1,000 patients. However African-American patients had a two-fold increased rate of amputation compared to white patients. This increased risk of amputation was similar for Hispanic patients as well.
Examining the state-by-state and regional data, the data found that regions with a higher level of diagnosed PAD and diabetes had a lower rate of amputation. This suggests that regions where diagnosed PAD and diabetes is lower, tend to lack the healthcare infrastructure and resources to manage diabetic patients and test for related chronic conditions that have an impact on patient outcomes.
The author of the research concluded that: “Regardless of location or prevalence of disease, people of color are disproportionally at higher risk for amputation. Black patients in areas with the lowest rates of PAD and diabetes are disproportionally the highest risk for amputation overall.”