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GEOGRAPHIC VARIATION OF LOWER EXTREMITY AMPUTATION IN PATIENTS WITH PERIPHERAL ARTERY DISEASE: RESULTS FROM U.S. MEDICARE 2000-2008
E1670 JACC March 27, 2012 Volume 59, Issue 13
Prevention GEOGRAPHIC VARIATION OF LOWER EXTREMITY AMPUTATION IN PATIENTS WITH PERIPHERAL ARTERY DISEASE: RESULTS FROM U.S. MEDICARE 2000-2008 ACC Moderated Poster Contributions McCormick Place South, Hall A Sunday, March 25, 2012, 9:30 a.m.-10:30 a.m.
Session Title: Prevention: Clinical: Beyond the Heart - What’s New in Vascular Disease Abstract Category: 9. Prevention: Clinical Presentation Number: 1186-377 Authors: William Schuyler Jones, Manesh Patel, Dadi (David) Dai, Sumeet Subherwal, Judith Stafford, Sarah Calhoun, Eric Peterson, Duke University Medical Center, Durham, NC, USA Background: Lower extremity (LE) amputations represent a failure of treatment for patients with peripheral artery disease (PAD) yet little is known about the geographic variation in performance of LE amputation. Methods: Using data from the Centers for Medicare & Medicaid Services (CMS) from January 1, 2000 to December 31, 2008, we examined national patterns of PAD with and without LE amputation among patients 65 years or older. U.S. Census Bureau regions and divisions were used to investigate geographic variation. Multivariable logistic regression was used to adjust regional results for other patient demographic and clinical factors. Results: Overall rate of LE amputation was 7.4% in PAD patients and varied from 5.4% to 8.5% among regions (see Figure). After adjustment for demographic and clinical characteristics, there was significant geographic variation in the odds of LE amputation, with the eastern U.S. having high rates of LE amputation (NE region odds ratio, 1.16; 95% CI, 1.13-1.18). Conclusions: Significant geographic variation exists in the rate of non-traumatic LE amputation in the United States. Further study is needed to determine the reasons for these geographic differences.
Prevention GEOGRAPHIC VARIATION OF LOWER EXTREMITY AMPUTATION IN PATIENTS WITH PERIPHERAL ARTERY DISEASE: RESULTS FROM U.S. MEDICARE 2000-2008 ACC Moderated Poster Contributions McCormick Place South, Hall A Sunday, March 25, 2012, 9:30 a.m.-10:30 a.m.
Session Title: Prevention: Clinical: Beyond the Heart - What’s New in Vascular Disease Abstract Category: 9. Prevention: Clinical Presentation Number: 1186-377 Authors: William Schuyler Jones, Manesh Patel, Dadi (David) Dai, Sumeet Subherwal, Judith Stafford, Sarah Calhoun, Eric Peterson, Duke University Medical Center, Durham, NC, USA Background: Lower extremity (LE) amputations represent a failure of treatment for patients with peripheral artery disease (PAD) yet little is known about the geographic variation in performance of LE amputation. Methods: Using data from the Centers for Medicare & Medicaid Services (CMS) from January 1, 2000 to December 31, 2008, we examined national patterns of PAD with and without LE amputation among patients 65 years or older. U.S. Census Bureau regions and divisions were used to investigate geographic variation. Multivariable logistic regression was used to adjust regional results for other patient demographic and clinical factors. Results: Overall rate of LE amputation was 7.4% in PAD patients and varied from 5.4% to 8.5% among regions (see Figure). After adjustment for demographic and clinical characteristics, there was significant geographic variation in the odds of LE amputation, with the eastern U.S. having high rates of LE amputation (NE region odds ratio, 1.16; 95% CI, 1.13-1.18). Conclusions: Significant geographic variation exists in the rate of non-traumatic LE amputation in the United States. Further study is needed to determine the reasons for these geographic differences.