S. Jhajj1, V. Pandit1, K. Goshima1, C. Weinkauf1, W. Zhou1, G. Doros2, D. Rybin2, T. Tan1 1University Of Arizona,Department Of Surgery,Tucson, AZ, USA 2Boston University,Boston, MA, USA
Introduction:
Recent studies have suggested racial and ethnic disparities in lower extremity amputation. The goal of our study was to determine whether race impact the perioperative outcomes following above knee amputation (AKA) and below knee amputation (BKA).
Methods:
The ACS-National Surgical Quality Initiative Program (2012 to 2016) was queried to identify patients who underwent major amputation (AKA and BKA) using CPT-codes. Outcomes evaluated include perioperative mortality and morbidity, hospital length of stay (LOS) and readmission. Multivariable regression analyses were performed to assess the association between race/ethnicity and outcomes.
Results:
There were 19,293 major amputations (7,528 AKAs) in the study cohort, including 11,564 Whites, 5,380 African Americans (AAs), 1,767 Hispanics, 310 Asians, and 272 Native Americans (NAs). Overall, the average age was 64.2 years, 65.7% male and 64% had diabetes. The perioperative mortality was 7.3% and average LOS was 11.5 days. In risk-adjusted analyses, AAs had significantly lower mortality (OR 0.81, 95% CI 0.7,0.9, p=.002) and surgical site infection (OR 0.74, 95% CI 0.6,0.8, p<.001) when comparison was made with Whites. The hospital LOS was significantly longer (all p<.001) for AAs (OR 1.06, 95% CI 1.03,1.09), Hispanics (OR 1.06, 95% CI 1.02,1.10), Asians (OR 1.47, 95% CI 1.35,1.60) and NAs (OR 1.32, 95% CI 1.2, 1.44), compared to White counterparts.
Conclusion:
Although race is not a significant factor impacting perioperative mortality and morbidity following major amputations, the hospital length of stay is significantly longer for AAs and other racial groups than their White counterparts. Further study is required to understand the impact of the racial and ethnic group on hospital stay and other resource utilization following lower extremity amputation.
