Racial Differences in Vascular Assessment Prior to Amputation in the Veterans Health Administration

Olamide Alabi; Kelly J Hunt; Rachel E Patzer; Tabia Henry Akintobi; Nader N Massarweh

doi:10.1089/heq.2023.0004

Racial Differences in Vascular Assessment Prior to Amputation in the Veterans Health Administration

Health Equity. 2023 May 26;7(1):346-350. doi: 10.1089/heq.2023.0004. eCollection 2023.

Authors

Olamide Alabi^{1

2}, Kelly J Hunt^{3

4}, Rachel E Patzer⁵, Tabia Henry Akintobi⁶, Nader N Massarweh^{1

7

8}

Affiliations

¹ Surgical and Perioperative Care, Atlanta VA Health Care System, Decatur, Georgia, USA.
² Division of Vascular Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
³ Charleston Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.
⁴ Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
⁵ Health Services Research Center, Emory University School of Medicine, Atlanta, Georgia, USA.
⁶ Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA.
⁷ Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
⁸ Department of Surgery, Morehouse School of Medicine, Atlanta, Georgia, USA.

Abstract

Purpose: It is unclear whether disparities in the care provided before lower extremity amputation (LEA) is driven by differences in receipt of diagnostic work-up versus revascularization attempts.

Methods: We performed a national cohort study of Veterans who underwent LEA between March 2010 and February 2020 to assess receipt of vascular assessment with arterial imaging and/or revascularization in the year prior to LEA.

Results: Among 19,396 veterans (mean age 66.8 years; 26.6% Black), Black veterans had diagnostic procedures more often than White veterans (47.5% vs. 44.5%) and revascularization as often (25.8% vs. 24.5%).

Conclusion: We must identify patient and facility-level factors associated with LEA as disparities do not appear related to differences in attempted revascularization.

Keywords: amputation; peripheral artery disease; quality of care; racial disparities; vascular assessment.