ArticlePM & R : the journal of injury, function, and rehabilitation2022
Racial and ethnic amputation level disparities in veterans undergoing incident dysvascular lower extremity amputation.
Article in PM & R : the journal of injury, function, and rehabilitation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis 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.
The trial behind it
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 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
- Peripheral neuropathy prevalence and effect on mobility 12 months after prosthesis prescription among individuals with dysvascular lower extremity amputation.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- Racial disparities in prosthesis abandonment and mobility outcomes after lower limb amputation from a dysvascular etiology in a veteran population.PM & R : the journal of injury, function, and rehabilitation · 2025Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe choice of incident amputation level can have a profound effect on clinical outcomes. Amputations at the transmetatarsal (TM) or transtibial (TT) levels result in greater preservation of function and mobility, whereas transfemoral (TF) amputations typically result in a greater adverse impact. Prior investigations have explored racial/ethnic and regional variation in incident amputation level. This study overcomes some of the methodological limitations seen in prior research through the use of a large national, multiyear veteran sample and by including only those who have undergone an incident amputation.
objectives(1) Determine if there are national/regional differences in the frequency of incident TF amputation compared with TM and TT amputation, (2) Determine if race/ethnicity and geographic region are associated with incident TF amputation level, and (3) Determine if racial/ethnic disparities of incident TF amputation differ by the presence of diabetes or prior revascularization.
designRetrospective cohort study of veterans undergoing an incident dysvascular lower extremity amputation.
settingOne hundred ten Veterans Affairs (VA) Medical Centers.
participantsSeven thousand two hundred ninety-six Veterans undergoing incident unilateral dysvascular lower extremity amputation identified in the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database (2005-2014).
interventionsNot applicable.
main outcome measureIncident amputation level.
resultsThe White, Black, and Hispanic risk for an incident TF amputation was 31% (n = 1356), 35% (n = 810), and 46% (n = 293), respectively. In the Continental region, Blacks who had not had a prior revascularization were more likely to undergo a TF amputation compared to Whites both with and without diabetes (odds ratio [OR] = 1.4; 95% confidence interval [CI], 1.1, 1.9 and OR = 1.5; 95% CI, 1.1, 2.1, respectively). In the Southeast region, Hispanics compared with Whites were at increased odds of undergoing a TF amputation, irrespective of a diabetes or a prior revascularization (ORs ≥ 2.9).
conclusionsRacial and ethnic disparities exist in choice of proximal compared with distal amputation in specific VA geographic regions.
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Registered trials
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