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  • Lower-extremity bypass chronic limb-threatening ischemia increases odds of amputation and other complications.

Black patients and socioeconomically disadvantaged patients tend to present with more advanced peripheral artery disease (PAD) — lower-extremity bypass chronic limb-threatening ischemia (CLTI), according to a study published online April 13 in the Annals of Surgery.

Chloé A. Powell, M.D., from the University of Michigan in Ann Arbor, and colleagues evaluated the potential pathway through which race and socioeconomic status affect outcomes following lower-extremity bypass CLTI, a marker for delayed presentation. The analysis included 7,077 patients who underwent a lower-extremity bypass procedure.

The researchers found that Black patients had a higher prevalence of CLTI (80.6 versus 66.4 percent). There were significant indirect effects identified where Black patients were more likely to present with CLTI and thus had increased odds of 30-day amputation (odds ratio [OR], 1.11), one-year amputation (OR, 1.08), and surgical site infection (OR, 1.05). Similarly, there were significant indirect effects observed, with patients in the fifth quintile for social deprivation index more likely to present with CLTI and thus have increased odds of 30-day amputation (OR, 1.06) and surgical site infection (OR, 1.03), as well as one-year amputation (OR, 1.07) and surgical site infection (OR, 1.03).

“Health care providers need to recognize the vulnerability of certain subgroups to adverse outcomes and be on alert for early signs and symptoms of PAD to manage patients accordingly,” Powell said in a statement.

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