Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 7/2011

01-07-2011 | Symposium: AAOS/ORS/ABJS Musculoskeletal Healthcare Disparities Research Symposium

Disparities in Amputations in Minorities

Authors: Kristin M. Lefebvre, PT, PhD, CCS, Lawrence A. Lavery, DPM, MPH

Published in: Clinical Orthopaedics and Related Research® | Issue 7/2011

Login to get access

Abstract

Background

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.

Questions/purposes

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.

Methods

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.
Literature
1.
go back to reference Aboyans V, McClelland RL, Allison MA, McDermott MM, Goff DC, Manolio TA. Intrinsic contribution of gender and ethnicity to normal ankle-brachial index values: the Multi-Ethnic Study of Atherosclerosis (MESA). J Vasc Surg. 2007;45:319–327.PubMedCrossRef Aboyans V, McClelland RL, Allison MA, McDermott MM, Goff DC, Manolio TA. Intrinsic contribution of gender and ethnicity to normal ankle-brachial index values: the Multi-Ethnic Study of Atherosclerosis (MESA). J Vasc Surg. 2007;45:319–327.PubMedCrossRef
2.
go back to reference 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. 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.
3.
go back to reference Allen J, Szanton S. Gender, ethnicity, and cardiovascular disease. J Cardiovasc Nurs. 2005;20:1–6.PubMed Allen J, Szanton S. Gender, ethnicity, and cardiovascular disease. J Cardiovasc Nurs. 2005;20:1–6.PubMed
4.
go back to reference Ashry HR, Lavery LA. Armstrong DG. Lavery DC. Cost of diabetes related amputations in minorities. J Foot Ankle Surg. 1998;37:186–190.PubMedCrossRef Ashry HR, Lavery LA. Armstrong DG. Lavery DC. Cost of diabetes related amputations in minorities. J Foot Ankle Surg. 1998;37:186–190.PubMedCrossRef
6.
go back to reference 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. 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.
7.
go back to reference 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.PubMed 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.PubMed
8.
go back to reference Clark L. Issues in minority health: atherosclerosis and coronary heart disease in African Americans. Med Clin North Am. 2005;89:977–1001.PubMedCrossRef Clark L. Issues in minority health: atherosclerosis and coronary heart disease in African Americans. Med Clin North Am. 2005;89:977–1001.PubMedCrossRef
9.
go back to reference Collins N. Diabetes, nutrition and wound healing. Advances in Skin and Wound Care. 2003;16:291–294.PubMedCrossRef Collins N. Diabetes, nutrition and wound healing. Advances in Skin and Wound Care. 2003;16:291–294.PubMedCrossRef
10.
go back to reference 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. 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.
11.
go back to reference Dillingham TR, Pezzin LE, MacKenzie EJ. Limb amputation and limb deficiency: epidemiology and recent trends in the United States. South Med J. 2002; 95:875–883.PubMed Dillingham TR, Pezzin LE, MacKenzie EJ. Limb amputation and limb deficiency: epidemiology and recent trends in the United States. South Med J. 2002; 95:875–883.PubMed
12.
go back to reference Dillingham TR, Pezzin LE, Mackenzie EJ. Racial differences in the incidence of limb loss secondary to peripheral vascular disease: a population-based study. Arch Phys Med Rehabil. 2005;83:1252–1257.CrossRef Dillingham TR, Pezzin LE, Mackenzie EJ. Racial differences in the incidence of limb loss secondary to peripheral vascular disease: a population-based study. Arch Phys Med Rehabil. 2005;83:1252–1257.CrossRef
13.
go back to reference Doescher MP, Saver BG, Franks P, Fiscella K. Racial and ethnic disparities in perceptions of physician style and trust. Arch Fam Med. 2000;9:1156–1163.PubMedCrossRef Doescher MP, Saver BG, Franks P, Fiscella K. Racial and ethnic disparities in perceptions of physician style and trust. Arch Fam Med. 2000;9:1156–1163.PubMedCrossRef
14.
go back to reference Eggers PW, Gohdes D, Pugh J. Nontraumatic lower extremity amputations in the Medicare end-stage renal disease population. Kidney Int. 1999;56:1524–1533.PubMedCrossRef Eggers PW, Gohdes D, Pugh J. Nontraumatic lower extremity amputations in the Medicare end-stage renal disease population. Kidney Int. 1999;56:1524–1533.PubMedCrossRef
15.
go back to reference Ephraim PL, Dillingham TR, Sector M, Pezzin LE, Mackenzie EJ. Epidemiology of limb loss and congenital limb deficiency: a review of the literature. Arch Phys Med Rehabil. 2003;84:747–761.PubMed Ephraim PL, Dillingham TR, Sector M, Pezzin LE, Mackenzie EJ. Epidemiology of limb loss and congenital limb deficiency: a review of the literature. Arch Phys Med Rehabil. 2003;84:747–761.PubMed
16.
go back to reference Eslami MH, Zayaruzny M, Fitzgerald GA. The adverse effects of race, insurance status, and low income on the rate of amputation in patients presenting with lower extremity ischemia. J Vasc Surg. 2007;45:55–59.PubMedCrossRef Eslami MH, Zayaruzny M, Fitzgerald GA. The adverse effects of race, insurance status, and low income on the rate of amputation in patients presenting with lower extremity ischemia. J Vasc Surg. 2007;45:55–59.PubMedCrossRef
17.
go back to reference Feinglass J, Abadin S, Thompson J, Pearce WH. A census based analysis of racial disparities in lower extremity amputation rates in Northern Illinois, 1987–2004. J Vasc Surg. 2008;47:1001–1007.PubMedCrossRef Feinglass J, Abadin S, Thompson J, Pearce WH. A census based analysis of racial disparities in lower extremity amputation rates in Northern Illinois, 1987–2004. J Vasc Surg. 2008;47:1001–1007.PubMedCrossRef
18.
go back to reference Feinglass J, Rucker-Whitaker C, Lindquist L, McCarthy WJ, Pearce WH. Racial differences in primary and repeat lower extremity amputation: results from a multihospital study. J Vasc Surg. 2005;41:823–829.PubMedCrossRef Feinglass J, Rucker-Whitaker C, Lindquist L, McCarthy WJ, Pearce WH. Racial differences in primary and repeat lower extremity amputation: results from a multihospital study. J Vasc Surg. 2005;41:823–829.PubMedCrossRef
19.
go back to reference Fletcher DD, Andrews KL, Butters MA, Jacobsen SJ, Rowland CM, Hallett JW Jr. Rehabilitation of the geriatric vascular amputee patient: a population-based study. Arch Phys Med Rehabil. 2001;82:776–779.PubMedCrossRef Fletcher DD, Andrews KL, Butters MA, Jacobsen SJ, Rowland CM, Hallett JW Jr. Rehabilitation of the geriatric vascular amputee patient: a population-based study. Arch Phys Med Rehabil. 2001;82:776–779.PubMedCrossRef
20.
go back to reference Gadegbeku CA, Lea JP, Jamerson KA. Update on disparities in pathophysiology and management of hypertension: focus on African Americans. Med Clin N Am. 2005;89:921–933.PubMedCrossRef Gadegbeku CA, Lea JP, Jamerson KA. Update on disparities in pathophysiology and management of hypertension: focus on African Americans. Med Clin N Am. 2005;89:921–933.PubMedCrossRef
21.
go back to reference Gornick ME, Eggers PW, Reilly TW, Mentnech RM, Fitterman LK, Kucken LE, Vladeck BC. Effects of race and income on mortality and use of services among Medicare beneficiaries. N Engl J Med. 1996;335:791–799.PubMedCrossRef Gornick ME, Eggers PW, Reilly TW, Mentnech RM, Fitterman LK, Kucken LE, Vladeck BC. Effects of race and income on mortality and use of services among Medicare beneficiaries. N Engl J Med. 1996;335:791–799.PubMedCrossRef
22.
go back to reference Guadagnoli E, Ayanian JZ, Gibbons G. The influence of race on the use of surgical procedures for treatment of peripheral arterial disease of the lower extremities. Arch Surg. 1995;130:381–386.PubMed Guadagnoli E, Ayanian JZ, Gibbons G. The influence of race on the use of surgical procedures for treatment of peripheral arterial disease of the lower extremities. Arch Surg. 1995;130:381–386.PubMed
23.
go back to reference Halpern CT, Hallfors D, Bauer DJ, Iritani B, Waller MW, Cho H. Implications of racial and gender differences in patterns of adolescent risk behavior for HIV and other sexually transmitted diseases. Perspect Sex Repro H. 2004;36:239–247.CrossRef Halpern CT, Hallfors D, Bauer DJ, Iritani B, Waller MW, Cho H. Implications of racial and gender differences in patterns of adolescent risk behavior for HIV and other sexually transmitted diseases. Perspect Sex Repro H. 2004;36:239–247.CrossRef
24.
go back to reference Huang CT, Jackson JR, Moore NB, Fine PR, Kuhlemeier KV, Traugh GH, Saunders P. Amputation: energy cost of ambulation. Arch Phys Med Rehabil. 1979;60:18–24.PubMed Huang CT, Jackson JR, Moore NB, Fine PR, Kuhlemeier KV, Traugh GH, Saunders P. Amputation: energy cost of ambulation. Arch Phys Med Rehabil. 1979;60:18–24.PubMed
25.
go back to reference Huber TS, Wang JG, Wheeler KG, Cuddeback JK, Dame DA, Ozaki CK, Flynn TC, Seeger JM. Impact of race on the treatment for peripheral arterial occlusive disease. J Vasc Surg. 1999;30:417–425.PubMedCrossRef Huber TS, Wang JG, Wheeler KG, Cuddeback JK, Dame DA, Ozaki CK, Flynn TC, Seeger JM. Impact of race on the treatment for peripheral arterial occlusive disease. J Vasc Surg. 1999;30:417–425.PubMedCrossRef
26.
go back to reference Iribarren C, Sidney S, Sternfeld B, Browner WS. Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke and peripheral vascular disease. JAMA. 2000;283:2810–2815.PubMedCrossRef Iribarren C, Sidney S, Sternfeld B, Browner WS. Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke and peripheral vascular disease. JAMA. 2000;283:2810–2815.PubMedCrossRef
27.
go back to reference Jaegers SM, Arendzen JH, de Jongh HJ. Prosthetic gait of unilateral transfemoral amputees: a kinematic study. Arch Phys Med Rehabil. 1995;76:736–743.PubMedCrossRef Jaegers SM, Arendzen JH, de Jongh HJ. Prosthetic gait of unilateral transfemoral amputees: a kinematic study. Arch Phys Med Rehabil. 1995;76:736–743.PubMedCrossRef
28.
go back to reference Karter AJ, Ferrara A, Liu JY, Moffet HH, Ackerson LM, Selby JV. Ethnic disparities in diabetic complications in an insured population. JAMA. 2002;287:2519–2527.PubMedCrossRef Karter AJ, Ferrara A, Liu JY, Moffet HH, Ackerson LM, Selby JV. Ethnic disparities in diabetic complications in an insured population. JAMA. 2002;287:2519–2527.PubMedCrossRef
29.
go back to reference Keil JE, Sutherland SE, Knapp RG, Lackland DT, Gazes PC, Tyroler HA. Mortality rates and risk factors for coronary disease in black as compared with white men and women. N Engl J Med. 1993;329:73–78.PubMedCrossRef Keil JE, Sutherland SE, Knapp RG, Lackland DT, Gazes PC, Tyroler HA. Mortality rates and risk factors for coronary disease in black as compared with white men and women. N Engl J Med. 1993;329:73–78.PubMedCrossRef
30.
go back to reference Lantz PM, Lynch JW, House JS, Lepkowski JM, Mero RP, Musick MA, Williams DR. Socioeconomic disparities in health change in a longitudinal study of US adults: the role of health-risk behaviors. Soc Sci Med. 2001;53:29–40.PubMedCrossRef Lantz PM, Lynch JW, House JS, Lepkowski JM, Mero RP, Musick MA, Williams DR. Socioeconomic disparities in health change in a longitudinal study of US adults: the role of health-risk behaviors. Soc Sci Med. 2001;53:29–40.PubMedCrossRef
31.
go back to reference LaVeist TA, Thorpe RJ Jr, Galarraga JE. Environmental and socioeconomic factors as contributors to racial disparities in diabetes prevalence. J Gen Intern Med. 2009;24:1144–1148.PubMedCrossRef LaVeist TA, Thorpe RJ Jr, Galarraga JE. Environmental and socioeconomic factors as contributors to racial disparities in diabetes prevalence. J Gen Intern Med. 2009;24:1144–1148.PubMedCrossRef
32.
go back to reference 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. 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.
33.
go back to reference Lefebvre KM, Metraux S. Disparities in level of amputation: implications for improved preventative care. J Natl Med Assoc. 2009;101:649–655.PubMed Lefebvre KM, Metraux S. Disparities in level of amputation: implications for improved preventative care. J Natl Med Assoc. 2009;101:649–655.PubMed
34.
go back to reference Link B, Pelan J. McKeown and the idea that social conditions are fundamental causes of disease. Am J Public Health. 2002;92:730–733.PubMedCrossRef Link B, Pelan J. McKeown and the idea that social conditions are fundamental causes of disease. Am J Public Health. 2002;92:730–733.PubMedCrossRef
35.
go back to reference McBean AM, Gornick M. Differences by race in the rates of procedures performed in hospitals for Medicare beneficiaries. Health Care Financ Rev. 1994;15:77–90.PubMed McBean AM, Gornick M. Differences by race in the rates of procedures performed in hospitals for Medicare beneficiaries. Health Care Financ Rev. 1994;15:77–90.PubMed
36.
go back to reference 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.PubMed 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.PubMed
37.
go back to reference Miller WC, Speechley M, Deathe AB. Balance confidence among people with lower-limb amputations. Phys Ther. 2002;82:856–865.PubMed Miller WC, Speechley M, Deathe AB. Balance confidence among people with lower-limb amputations. Phys Ther. 2002;82:856–865.PubMed
38.
go back to reference Millstein S, Bain D, Hunter GA. A review of employment patterns of industrial amputees—factors influencing rehabilitation. Prosthet Orthot Int. 1985;9:69–78.PubMed Millstein S, Bain D, Hunter GA. A review of employment patterns of industrial amputees—factors influencing rehabilitation. Prosthet Orthot Int. 1985;9:69–78.PubMed
39.
go back to reference Mitka M. Diabetes group warns vascular complication is underdiagnosed and undertreated. JAMA. 2004;291:809–810.PubMedCrossRef Mitka M. Diabetes group warns vascular complication is underdiagnosed and undertreated. JAMA. 2004;291:809–810.PubMedCrossRef
40.
go back to reference Moore TJ, Barron J, Hutchinson F 3rd, Golden C, Ellis C, Humphries D. Prosthetic usage following major lower extremity amputation. Clin Orthop Relat Res. 1989;238:219–224.PubMed Moore TJ, Barron J, Hutchinson F 3rd, Golden C, Ellis C, Humphries D. Prosthetic usage following major lower extremity amputation. Clin Orthop Relat Res. 1989;238:219–224.PubMed
41.
go back to reference Mort EA, Weissman JS, Epstein AM. Physician discretion and racial variation in the use of surgical procedures. Arch Intern Med. 1994;154:761–767.PubMedCrossRef Mort EA, Weissman JS, Epstein AM. Physician discretion and racial variation in the use of surgical procedures. Arch Intern Med. 1994;154:761–767.PubMedCrossRef
42.
go back to reference Nissen SJ, Newman WP. Factors influencing reintegration to normal living after amputation. Arch Phys Med Rehabil. 1992;73:548–551.PubMed Nissen SJ, Newman WP. Factors influencing reintegration to normal living after amputation. Arch Phys Med Rehabil. 1992;73:548–551.PubMed
43.
go back to reference Oddone EZ, Petersen LA, Weinberger M, Freedman J, Kressin NR. Contribution of the Veterans Health Administration in understanding racial disparities in access and utilization of health care: a spirit of inquiry. Med Care. 2002;40(Suppl):I3–13.PubMedCrossRef Oddone EZ, Petersen LA, Weinberger M, Freedman J, Kressin NR. Contribution of the Veterans Health Administration in understanding racial disparities in access and utilization of health care: a spirit of inquiry. Med Care. 2002;40(Suppl):I3–13.PubMedCrossRef
44.
go back to reference Ollendorf DA, Kotsanos JG, Wishner WJ, Friedman M, Cooper T, Bittoni M, Oster G, Potential economic benefits of lower-extremity amputation prevention strategies in diabetes. Diabetes Care. 1998;21:1240–1245.PubMedCrossRef Ollendorf DA, Kotsanos JG, Wishner WJ, Friedman M, Cooper T, Bittoni M, Oster G, Potential economic benefits of lower-extremity amputation prevention strategies in diabetes. Diabetes Care. 1998;21:1240–1245.PubMedCrossRef
45.
go back to reference Oster NV, Welch V, Schild L, Gazmararian JA, Rask K, Spettell C. Differences in self management behaviors and use of preventative services among diabetes management enrollees by race and ethnicity. Dis Manage. 2006;9:167–175.CrossRef Oster NV, Welch V, Schild L, Gazmararian JA, Rask K, Spettell C. Differences in self management behaviors and use of preventative services among diabetes management enrollees by race and ethnicity. Dis Manage. 2006;9:167–175.CrossRef
46.
go back to reference Patout CA Jr, Birke JA, Horswell R, Williams D, Cerise FP. Effectiveness of a comprehensive diabetes lower extremity amputation prevention program in a predominantly low income African American population. Diabetes Care. 2000;23:1339–1342.PubMedCrossRef Patout CA Jr, Birke JA, Horswell R, Williams D, Cerise FP. Effectiveness of a comprehensive diabetes lower extremity amputation prevention program in a predominantly low income African American population. Diabetes Care. 2000;23:1339–1342.PubMedCrossRef
47.
go back to reference Resnick HE, Valsania P, Phillips CL. Diabetes mellitus and nontraumatic lower extremity amputation in black and white Americans: the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, 1971–1992. Arch Intern Med. 1999;159:2470–2475.PubMedCrossRef Resnick HE, Valsania P, Phillips CL. Diabetes mellitus and nontraumatic lower extremity amputation in black and white Americans: the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, 1971–1992. Arch Intern Med. 1999;159:2470–2475.PubMedCrossRef
48.
go back to reference Rith-Najarian SJ, Reiber G. Prevention of foot problems in persons with diabetes. J Fam Pract. 2000;49:S30–39.PubMed Rith-Najarian SJ, Reiber G. Prevention of foot problems in persons with diabetes. J Fam Pract. 2000;49:S30–39.PubMed
49.
go back to reference Rucker-Whitaker C, Feinglass J, Pearce WH. Explaining racial variation in lower extremity amputation: a 5-year retrospective claims data and medical record review at an urban teaching hospital. Arch Surg. 2003;138:1347–1351.PubMedCrossRef Rucker-Whitaker C, Feinglass J, Pearce WH. Explaining racial variation in lower extremity amputation: a 5-year retrospective claims data and medical record review at an urban teaching hospital. Arch Surg. 2003;138:1347–1351.PubMedCrossRef
50.
go back to reference Schoppen T, Boonstra A, Groothoff JW, de Vries J, Göeken LN, Eisma WH. Employment status, job characteristics, and work-related health experience of people with a lower limb amputation in The Netherlands. Arch Phys Med Rehabil. 2001;82:239–245.PubMedCrossRef Schoppen T, Boonstra A, Groothoff JW, de Vries J, Göeken LN, Eisma WH. Employment status, job characteristics, and work-related health experience of people with a lower limb amputation in The Netherlands. Arch Phys Med Rehabil. 2001;82:239–245.PubMedCrossRef
51.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
52.
go back to reference Selvin P, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999–2000. Circulation. 2004;110:738–743.PubMedCrossRef Selvin P, Erlinger TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999–2000. Circulation. 2004;110:738–743.PubMedCrossRef
53.
go back to reference Tentolouris N, Al-Sabbagh S, Walker MG, Boulton AJ, Jude EB. Mortality in diabetic and nondiabetic patients after amputations performed from 1990 to 1995: a 5-year follow-up study. Diabetes Care. 2004;27:1598–1604.PubMedCrossRef Tentolouris N, Al-Sabbagh S, Walker MG, Boulton AJ, Jude EB. Mortality in diabetic and nondiabetic patients after amputations performed from 1990 to 1995: a 5-year follow-up study. Diabetes Care. 2004;27:1598–1604.PubMedCrossRef
54.
go back to reference Tunis SR, Bass EB, Klag MJ, Steinberg EP. Variation in utilization of procedures for treatment of peripheral arterial disease: a look at patient characteristics. Arch Intern Med. 1993;153:991–998.PubMedCrossRef Tunis SR, Bass EB, Klag MJ, Steinberg EP. Variation in utilization of procedures for treatment of peripheral arterial disease: a look at patient characteristics. Arch Intern Med. 1993;153:991–998.PubMedCrossRef
55.
go back to reference Van Houtum WH, Lavery LA, Armstrong DG. Risk factors for above-knee amputations in diabetes mellitus. South Med J. 1998;91:643–649.PubMedCrossRef Van Houtum WH, Lavery LA, Armstrong DG. Risk factors for above-knee amputations in diabetes mellitus. South Med J. 1998;91:643–649.PubMedCrossRef
56.
go back to reference van Ryn M. Research on the provider contribution to race/ethnicity disparities in medical care. Med Care. 2002;40(Suppl):I140–151.PubMed van Ryn M. Research on the provider contribution to race/ethnicity disparities in medical care. Med Care. 2002;40(Suppl):I140–151.PubMed
57.
go back to reference Whyte AS, Carroll LJ. A preliminary examination of the relationship between employment, pain and disability in an amputee population. Disabil Rehabil. 2002;24:462–470.PubMedCrossRef Whyte AS, Carroll LJ. A preliminary examination of the relationship between employment, pain and disability in an amputee population. Disabil Rehabil. 2002;24:462–470.PubMedCrossRef
58.
go back to reference Young BA, Maynard C, Reiber G, Boyko EJ. Effects of ethnicity and nephropathy on lower-extremity amputation risk among diabetic veterans. Diabetes Care. 2003;26:495–501.PubMedCrossRef Young BA, Maynard C, Reiber G, Boyko EJ. Effects of ethnicity and nephropathy on lower-extremity amputation risk among diabetic veterans. Diabetes Care. 2003;26:495–501.PubMedCrossRef
Metadata
Title
Disparities in Amputations in Minorities
Authors
Kristin M. Lefebvre, PT, PhD, CCS
Lawrence A. Lavery, DPM, MPH
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 7/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-011-1842-x

Other articles of this Issue 7/2011

Clinical Orthopaedics and Related Research® 7/2011 Go to the issue

Symposium: AAOS/ORS/ABJS Musculoskeletal Healthcare Disparities Research Symposium

Implant Survival, Knee Function, and Pain Relief After TKA: Are There Differences Between Men and Women?