ArticleSurgery2020
Racial and ethnic disparities in lower extremity amputation: Assessing the role of frailty in older adults.
Article in Surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
What it found
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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.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Outcomes following major dysvascular lower limb amputation: an updated systematic review.BMC cardiovascular disorders · 2026Pooled it
- Interplay between frailty and cardiometabolic disorders: from pathophysiology to clinical implications.Cardiovascular diabetology · 2025Pooled it
- Prediction model for cognitive frailty in older adults: A systematic review and critical appraisal.Frontiers in aging neuroscience · 2023Pooled it
- Association of Frailty and Postoperative Outcomes across Race and Ethnicity.Journal of racial and ethnic health disparities · 2025Article
- 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
- The Five-Item Modified Frailty Index Predicts Adverse Surgical Outcomes in Patients Undergoing Mastectomy.Annals of surgical oncology · 2025Article
- A systematic review of racial/ethnic disparities in pharmacotherapy and surgical treatment outcomes in peripheral arterial disease among African American/non-Hispanic Black, non-Hispanic White and Hispanic patients.American heart journal plus : cardiology research and practice · 2022Article
- Disparities in peripheral artery disease care: A review and call for action.Seminars in vascular surgery · 2022Review
- Geographic and Ethnic Inequalities in Diabetes-Related Amputations.Frontiers in clinical diabetes and healthcare · 2022Review
- Chronic Lower Extremity Ischemia and Its Association with the Frailty Syndrome in Patients with Diabetes.International journal of environmental research and public health · 2020Review
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundFrailty is a state of decreased physiologic reserve contributing to functional decline and is associated with adverse surgical outcomes, particularly in the elderly. Racial disparities have been reported previously both in frail individuals and in limb-salvage patients. Our goal was to assess whether race and ethnicity are disproportionately linked to frailty status in geriatric patients undergoing lower-limb amputation, leading to an increased risk of complications.
methodsA 3-year analysis was conducted of the National Surgical Quality Improvement Program database and included all geriatric (age ≥65 years) patients who underwent amputation of the lower limb. The frailty index was calculated using the 11-factor modified frailty index with a cutoff limit of 0.27 defined for frail status. Outcomes were 30-day complications, mortality, and readmissions. Multivariate regression analysis was performed.
resultsA total of 4,218 geriatric patients underwent surgical amputation of a lower extremity (above knee: 41%; below knee: 59%). Of these patients, 29% were frail, 26% were African American, and 9% were Hispanic. Being African American (odds ratio: 1.6 [1.3-1.9]) and Hispanic (odds ratio: 1.1 [1.05-2.5]) was independently associated with frail status. Frail African Americans had a higher likelihood of 30-day complications (odds ratio: 3.2 [1.9-4.4]) and 30-day readmissions (odds ratio: 2.9 [1.8-3.6]) when compared with nonfrail individuals. Similarly, frail Hispanics had higher 30-day complications (odds ratio: 2.6 [1.9-3.1]) and 30-day readmissions (odds ratio: 1.4 [1.1-2.7]) compared with nonfrail Hispanics/Latinos.
conclusionAfrican American and Hispanic geriatric patients undergoing lower-limb amputation are at increased risk for frailty status and, as a result, increased associated operative complications. These disparities exist regardless of age, sex, comorbid conditions, and location of amputation. Further studies are needed to highlight disparities by race and ethnicity to identify potentially modifiable risk factors, decrease frailty, and improve outcomes.
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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.