Risks and Benefits of the Proposed Amputation Reduction and Compassion Act for Disadvantaged Patients

Overview

Journal Ann Vasc Surg

Publisher Elsevier

Specialties Cardiology & Vascular Diseases
General Surgery

Date 2023 Dec 24

PMID 38142961

Authors

Midori White

Katherine M McDermott

Sanuja Bose

Caroline Wang

Tara Srinivas

Corey Kalbaugh

Caitlin W Hicks

Affiliations

Soon will be listed here.

Abstract

Racial, ethnic, and socioeconomic disparities in the major risk factors for vascular disease and access to vascular specialist care are well-documented. The higher incidence of diabetes, peripheral artery disease (PAD), and related nontraumatic lower extremity amputation among racial and ethnic minority groups, those of low socioeconomic status, and those with poor access to care based on geography (together, referred to below as disadvantaged groups) are particularly pervasive. Practitioners of vascular surgery and endovascular therapy are uniquely positioned to address health inequities in lower extremity screening, medical management, intervention, and limb preservation among the population of adults at the highest risk for limb loss.

References

Armstrong D, Boulton A, Bus S . Diabetic Foot Ulcers and Their Recurrence. N Engl J Med. 2017; 376(24):2367-2375. DOI: 10.1056/NEJMra1615439. View

Hicks C, Holscher C, Wang P, Black 3rd J, Abularrage C, Makary M . Overuse of early peripheral vascular interventions for claudication. J Vasc Surg. 2019; 71(1):121-130.e1. DOI: 10.1016/j.jvs.2019.05.005. View

Wukich D, Raspovic K, Suder N . Patients With Diabetic Foot Disease Fear Major Lower-Extremity Amputation More Than Death. Foot Ankle Spec. 2017; 11(1):17-21. DOI: 10.1177/1938640017694722. View

Barnes J, Eid M, Creager M, Goodney P . Epidemiology and Risk of Amputation in Patients With Diabetes Mellitus and Peripheral Artery Disease. Arterioscler Thromb Vasc Biol. 2020; 40(8):1808-1817. PMC: 7377955. DOI: 10.1161/ATVBAHA.120.314595. View

Arya S, Binney Z, Khakharia A, Brewster L, Goodney P, Patzer R . Race and Socioeconomic Status Independently Affect Risk of Major Amputation in Peripheral Artery Disease. J Am Heart Assoc. 2018; 7(2). PMC: 5850162. DOI: 10.1161/JAHA.117.007425. View

Sohn M, Kang H, Park J, Yates P, McCall A, Stukenborg G . Disparities in recommended preventive care usage among persons living with diabetes in the Appalachian region. BMJ Open Diabetes Res Care. 2017; 4(1):e000284. PMC: 5220277. DOI: 10.1136/bmjdrc-2016-000284. View

Semaan D, Abdul-Malak O, Avgerinos E, Chaer R, Madigan M, Siracuse J . Racial Disparities in Treatment Indications and Outcomes for Limb Ischemia. Ann Vasc Surg. 2023; 96:89-97. DOI: 10.1016/j.avsg.2023.04.022. View

Kalbaugh C, Witrick B, Sivaraj L, McGinigle K, Lesko C, Cykert S . Non-Hispanic Black and Hispanic Patients Have Worse Outcomes Than White Patients Within Similar Stages of Peripheral Artery Disease. J Am Heart Assoc. 2021; 11(1):e023396. PMC: 9075215. DOI: 10.1161/JAHA.121.023396. View

Alabi O, Beriwal S, Gallini J, Cui X, Jasien C, Brewster L . Association of Health Care Utilization and Access to Care With Vascular Assessment Before Major Lower Extremity Amputation Among US Veterans. JAMA Surg. 2023; 158(6):e230479. PMC: 10116382. DOI: 10.1001/jamasurg.2023.0479. View

10.

Fermawi S, Tolson J, Knapp S, Marrero D, Zhou W, Armstrong D . Disparities in preventative diabetic foot examination. Semin Vasc Surg. 2023; 36(1):84-89. PMC: 10503961. DOI: 10.1053/j.semvascsurg.2023.01.001. View

11.

Collins T, Johnson M, Henderson W, Khuri S, Daley J . Lower extremity nontraumatic amputation among veterans with peripheral arterial disease: is race an independent factor?. Med Care. 2002; 40(1 Suppl):I106-16. DOI: 10.1097/00005650-200201001-00012. View

12.

Kieback A, Gahwiler R, Thalhammer C . PAD screening: why? whom? when? how? - a systematic review. Vasa. 2020; 50(2):85-91. DOI: 10.1024/0301-1526/a000897. View

13.

Thiruvoipati T, Kielhorn C, Armstrong E . Peripheral artery disease in patients with diabetes: Epidemiology, mechanisms, and outcomes. World J Diabetes. 2015; 6(7):961-9. PMC: 4499529. DOI: 10.4239/wjd.v6.i7.961. View

14.

Adiewere P, Gillis R, Imran Jiwani S, Meal A, Shaw I, Adams G . A systematic review and meta-analysis of patient education in preventing and reducing the incidence or recurrence of adult diabetes foot ulcers (DFU). Heliyon. 2018; 4(5):e00614. PMC: 5986308. DOI: 10.1016/j.heliyon.2018.e00614. View

15.

Conte M, Bradbury A, Kolh P, White J, Dick F, Fitridge R . Global vascular guidelines on the management of chronic limb-threatening ischemia. J Vasc Surg. 2019; 69(6S):3S-125S.e40. PMC: 8365864. DOI: 10.1016/j.jvs.2019.02.016. View

16.

Eslami M, Dakour-Aridi H, Avgerinos E, Makaroun M, Malas M . Impact of Medicaid Expansion of the Affordable Care on the Outcomes of Lower Extremity Bypass for Patients With Peripheral Artery Disease in the Vascular Quality Initiative Database. Ann Surg. 2019; 270(4):647-655. DOI: 10.1097/SLA.0000000000003521. View

17.

Alabi O, Hunt K, Patzer R, Akintobi T, Massarweh N . Racial Differences in Vascular Assessment Prior to Amputation in the Veterans Health Administration. Health Equity. 2023; 7(1):346-350. PMC: 10240309. DOI: 10.1089/heq.2023.0004. View

18.

Eslami M, Zayaruzny M, FitzGerald G . 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(1):55-9. DOI: 10.1016/j.jvs.2006.09.044. View

19.

Curry S, Krist A, Owens D, Barry M, Caughey A, Davidson K . Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment With the Ankle-Brachial Index: US Preventive Services Task Force Recommendation Statement. JAMA. 2018; 320(2):177-183. DOI: 10.1001/jama.2018.8357. View

20.

Gerhard-Herman M, Gornik H, Barrett C, Barshes N, Corriere M, Drachman D . 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2016; 69(11):e71-e126. DOI: 10.1016/j.jacc.2016.11.007. View