ArticleBMJ open diabetes research & care2020
Association between race/ethnicity and the risk of amputation of lower extremities among medicare beneficiaries with diabetic foot ulcers and diabetic foot infections.
Article in BMJ open diabetes research & care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 68 citations in OpenAlex.
- A multicenter, randomized controlled clinical trial evaluating the effects of a novel autologous heterogeneous skin construct in the treatment of Wagner one diabetic foot ulcers: Final analysis.International wound journal · 2023Trial
- Taking a Load Off: User Perceptions of Smart Offloading Walkers for Diabetic Foot Ulcers Using the Technology Acceptance Model.Sensors (Basel, Switzerland) · 2023Trial
- Piloting a Postdischarge Virtual Glucose Monitoring Program for Patients With Diabetic Foot Wound in a Safety-Net Health System.Journal of diabetes science and technology · 2026Article
- Racial and microvascular determinants of progression to treatment-warranted diabetic eye disease.Eye (London, England) · 2026Article
- Racial and/or ethnic and rural disparities in health care utilization before major lower extremity amputation in patients with peripheral artery disease.Journal of vascular surgery · 2026Article
- Improving Limb Salvage Outcomes in Racially and Ethnically Underserved Populations With a Highly Integrated Multidisciplinary Approach.Plastic and reconstructive surgery. Global open · 2026Article
- Digital Health and Community-Based Care for Diabetic Foot Prevention and Management in Resource-Limited Settings: A Narrative Review.Journal of multidisciplinary healthcare · 2026Review
- Racial disparities in patients with amputation in an acute care setting in the immediate postoperative period.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- Educate African Americans with type 2 diabetes (T2DM) on the importance of daily foot self-care to prevent the development of diabetic foot ulcers (DFU): a quality improvement project.BMJ open quality · 2025Article
- Facility-Level Variation in Major Leg Amputation Among Patients With Newly Diagnosed Diabetic Foot Ulcer.JAMA network open · 2025Article
- Ineffective health maintenance behaviors in people with chronic conditions: Systematic review of etiology and risk.Heliyon · 2025Article
- Article
- Spatial associations between measures of public transportation and diabetic foot ulcer outcomes in the state of Georgia: 2016-2019.BMJ open diabetes research & care · 2024Article
- Racial Disparities in Foot Examination among People with Diabetes in Brazil: A Nationwide Survey, 2019.Ethnicity & disease · 2024Article
- Outcomes for Patients with Diabetic Foot Ulcers Following Transition from Medicaid to Commercial Insurance.Diabetology · 2024Article
- Evaluating the impact of an interdisciplinary integrated limb preservation service operating concurrently with a single-specialty service.Journal of foot and ankle research · 2024Article
- Assessing equity in the uptake of remote foot temperature monitoring in a large integrated US healthcare system.PloS one · 2024Article
- Nerve Block Extends Nerve Function Recovery in Patients with Diabetic Foot Ulcers.Journal of pain research · 2024Article
- Impact of Intensity of Vascular Care Preceding Major Amputation Among Patients With Chronic Limb-Threatening Ischemia.Circulation. Cardiovascular interventions · 2024Article
- Comorbidity and risk factors of subsequent lower extremity amputation in patients diagnosed with diabetes in Saskatchewan, Canada.Chronic illness · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
introductionThis study aimed to examine the association of race and ethnicity on the risk of lower extremity amputations among Medicare beneficiaries with diabetic foot ulcers (DFUs) and diabetic foot infections (DFIs). RESEARCH DESIGN AND
methodsA retrospective study included 2011-2015 data of a 5% sample of fee-for-service Medicare beneficiaries with a newly diagnosed DFU and/or DFI. The primary outcome was the time to the first major amputation episode after a DFU and/or DFI were identified using the diagnosis and procedure codes. We used multivariable Cox proportional hazards models to estimate the risk of time to the first major amputation across races, adjusting for sociodemographic and health status factors. Adjusted hazard ratios (aHRs) with a 95% CI were reported.
resultsAmong 92 929 Medicare beneficiaries newly diagnosed with DFUs and/or DFIs, 77% were whites, 14.3% African Americans (AAs), 3.3% Hispanics, 0.7% Native Americans (NAs), and 4.0% were other races. The incidence rates of major amputation were 0.02 person-years for NAs, 0.02 person-years for AAs, 0.01 person-years for Hispanics, 0.01 person-years for other races, and 0.01 person-years for whites (p<0.05). Multivariable analysis showed that AAs (aHR=1.9, 95% CI 1.7 to 2.2, p<0.0001) and NAs (aHR=1.8, 95% CI 1.3 to 2.6, p=0.001) were associated with an increased risk of major amputation compared with whites. Beneficiaries with DFUs and/or DFIs diagnosed by a podiatrist or primary care physician (aHR=0.7, 95% CI 0.6 to 0.8, p<0.0001, specialists as reference) or at an outpatient visit (aHR=0.3, 95% CI 0.3 to 0.3, p<0.0001, inpatient stay as reference) were associated with a decreased risk of major amputation.
conclusionsRacial and ethnic disparities in the risk of lower extremity amputations appear to exist among fee-for-service Medicare beneficiaries with diabetic foot problems. AAs and NAs with DFUs and/or DFIs were associated with an increased risk of major amputations compared with white Medicare beneficiaries.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.