Article

OBJECTIVE: To investigate amputation-free survival after infrainguinal bypass in
African Americans and Hispanics compared with non-Hispanic whites and to
determine the contribution of socioeconomic status to potential racial disparity.
DESIGN: This is a retrospective cohort study of subjects who underwent
infrainguinal bypass due to critical limb ischemia from 1997 through 2004.
The primary end point was major amputation or death, whichever occurred first.
Neighborhood socioeconomic status obtained from the 2000 United States Census was
used as a proxy for an individual's socioeconomic status. RESULTS: There were 595
subjects (237 non-Hispanic whites, 205 African Americans, 153 Hispanics) in the
study. Median amputation-free survival was 1.3, 3.3, and 3.2 yrs among Hispanics,
African Americans, and non-Hispanic whites, respectively. Hazard ratio for
amputation or death was 1.38 (95% confidence interval, 1.02-1.87) in Hispanics
and 0.81 (95% confidence interval, 0.63-1.16) in African Americans compared with
non-Hispanic whites after multivariable adjustment. For those residing in their
homes, adjusting for socioeconomic status attenuated the hazard ratio in
Hispanics to 1.08, explaining 78% of increased hazard.
CONCLUSIONS: There was no
significant difference between African Americans and non-Hispanic whites in
amputation-free survival after infrainguinal bypass. Hispanics were 1.4 times
more likely to have amputation or death than non-Hispanic whites, which was
largely explained by low socioeconomic status.

Langue : ANGLAIS