ArticleJournal of vascular surgery2021
Geographical socioeconomic disadvantage is associated with adverse outcomes following major amputation in diabetic patients.
Article in Journal of vascular surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Outcomes following major dysvascular lower limb amputation: an updated systematic review.BMC cardiovascular disorders · 2026Pooled it
- How Do Poverty, Insurance, and Government Assistance Impact Diabetic Foot Ulcer Outcomes? A Scoping Review.Diabetes/metabolism research and reviews · 2026Article
- Risk factors for re-amputation and major amputation following diabetic foot amputation: a clinical and socioeconomic perspective.BMC surgery · 2026Article
- Assessing the impact of social determinants of health on diabetes severity and management.JAMIA open · 2024Article
- Practice patterns of peripheral vascular interventions for peripheral artery disease in the office-based laboratory setting versus outpatient hospital.Journal of vascular surgery · 2024Article
- Residential Address Amplifies Health Disparities and Risk of Infection in Individuals With Diabetic Foot Ulcers.Diabetes care · 2024Article
- Association of Race, Ethnicity, and Gender to Disparities in Functional Recovery and Social Health After Major Lower Limb Amputation: A Cross-sectional Pilot Study.Archives of physical medicine and rehabilitation · 2024Article
- The impact of socioeconomic factors, social determinants, and ethnicity on the utilization of glucose sensor technology among persons with diabetes mellitus: a narrative review.Therapeutic advances in endocrinology and metabolism · 2024Review
- Vascular service provision during the COVID-19 pandemic worsened major amputation rates in socially deprived diabetic populations.Frontiers in endocrinology · 2024Article
- Comorbidity and risk factors of subsequent lower extremity amputation in patients diagnosed with diabetes in Saskatchewan, Canada.Chronic illness · 2023Article
- Implementation of a patient-centered remote wound monitoring system for management of diabetic foot ulcers.Frontiers in endocrinology · 2023Article
- Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers.Diabetes care · 2023Review
- Medicare Beneficiaries In Disadvantaged Neighborhoods Increased Telemedicine Use During The COVID-19 Pandemic.Health affairs (Project Hope) · 2022Article
- New Diabetic Medication Sodium-Glucose Cotransporter-2 Inhibitors Can Induce Euglycemic Ketoacidosis and Mimic Surgical Diseases: A Case Report and Review of Literature.Frontiers in surgery · 2022Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
objectiveSocioeconomic disadvantage is a known predictor of adverse outcomes and amputation in patients with diabetes. However, its association with outcomes after major amputation has not been described. Here, we aimed to determine the association of geographic socioeconomic disadvantage with 30-day readmission and 1-year reamputation rates among patients with diabetes undergoing major amputation.
methodsPatients from the Maryland Health Services Cost Review Commission Database who underwent major lower extremity amputation with a concurrent diagnosis of diabetes mellitus between 2015 and 2017 were stratified by socioeconomic disadvantage as determined by the area deprivation index (ADI) (ADI1 [least deprived] to ADI4 [most deprived]). The primary outcomes were rates of 30-day readmission and 1-year reamputation, evaluated using multivariable logistic regression models and Kaplan-Meier survival analyses.
resultsA total of 910 patients were evaluated (66.0% male, 49.2% Black), including 30.9% ADI1 (least deprived), 28.6% ADI2, 19.1% ADI3, and 21.2% ADI4 (most deprived). After adjusting for differences in baseline demographic and clinical factors, the odds of 30-day readmission was similar among ADI groups (P > .05 for all). Independent predictors of 30-day readmission included female sex (odds ratio [OR], 1.45), Medicare insurance (vs private insurance; OR, 1.76), and peripheral artery disease (OR, 1.49) (P < .05 for all). The odds of 1-year reamputation was significantly greater among ADI4 (vs ADI1; OR, 1.74), those with a readmission for stump complication or infection/sepsis (OR, 2.65), and those with CHF (OR, 1.53) or PAD (OR, 1.59) (P < .05 for all).
conclusionsGeographic socioeconomic disadvantage is independently associated with 1-year reamputation, but not 30-day readmission, among Maryland patients undergoing a major amputation for diabetes. A directed approach at improving postoperative management of chronic disease progression in socioeconomically deprived patients may be beneficial to reducing long-term morbidity in this high-risk group.
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