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Temporal trends and geographic variation of lower-extremity amputation in patients with peripheral artery disease: results from U.S. Medicare 2000-2008.

Publication ,  Journal Article
Jones, WS; Patel, MR; Dai, D; Subherwal, S; Stafford, J; Calhoun, S; Peterson, ED
Published in: J Am Coll Cardiol
November 20, 2012

OBJECTIVES: This study sought to characterize temporal trends, patient-specific factors, and geographic variation associated with amputation in patients with lower-extremity peripheral artery disease (LE PAD) during the study period. BACKGROUND: Amputation represents the end-stage failure for those with LE PAD, and little is known about the rates and geographic variation in the use of LE amputation. METHODS: By using data from the Centers for Medicare & Medicaid Services (CMS) from January 1, 2000, to December 31, 2008, we examined national patterns of LE amputation among patients age 65 years or more with PAD. Multivariable logistic regression was used to adjust regional results for other patient demographic and clinical factors. RESULTS: Among 2,730,742 older patients with identified PAD, the overall rate of LE amputation decreased from 7,258 per 100,000 patients with PAD to 5,790 per 100,000 (p < 0.001 for trend). Male sex, black race, diabetes mellitus, and renal disease were all independent predictors of LE amputation. The adjusted odds ratio of LE amputation per year between 2000 and 2008 was 0.95 (95% CI: 0.95-0.95, p < 0.001). CONCLUSIONS: From 2000 to 2008, LE amputation rates decreased significantly among patients with PAD. However, there remains significant patient and geographic variation in amputation rates across the United States.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

November 20, 2012

Volume

60

Issue

21

Start / End Page

2230 / 2236

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Prognosis
  • Population Surveillance
  • Peripheral Arterial Disease
  • Odds Ratio
  • Medicare
  • Male
 

Citation

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ICMJE
MLA
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Jones, W. S., Patel, M. R., Dai, D., Subherwal, S., Stafford, J., Calhoun, S., & Peterson, E. D. (2012). Temporal trends and geographic variation of lower-extremity amputation in patients with peripheral artery disease: results from U.S. Medicare 2000-2008. J Am Coll Cardiol, 60(21), 2230–2236. https://doi.org/10.1016/j.jacc.2012.08.983
Jones, W Schuyler, Manesh R. Patel, David Dai, Sumeet Subherwal, Judith Stafford, Sarah Calhoun, and Eric D. Peterson. “Temporal trends and geographic variation of lower-extremity amputation in patients with peripheral artery disease: results from U.S. Medicare 2000-2008.J Am Coll Cardiol 60, no. 21 (November 20, 2012): 2230–36. https://doi.org/10.1016/j.jacc.2012.08.983.
Jones WS, Patel MR, Dai D, Subherwal S, Stafford J, Calhoun S, et al. Temporal trends and geographic variation of lower-extremity amputation in patients with peripheral artery disease: results from U.S. Medicare 2000-2008. J Am Coll Cardiol. 2012 Nov 20;60(21):2230–6.
Jones, W. Schuyler, et al. “Temporal trends and geographic variation of lower-extremity amputation in patients with peripheral artery disease: results from U.S. Medicare 2000-2008.J Am Coll Cardiol, vol. 60, no. 21, Nov. 2012, pp. 2230–36. Pubmed, doi:10.1016/j.jacc.2012.08.983.
Jones WS, Patel MR, Dai D, Subherwal S, Stafford J, Calhoun S, Peterson ED. Temporal trends and geographic variation of lower-extremity amputation in patients with peripheral artery disease: results from U.S. Medicare 2000-2008. J Am Coll Cardiol. 2012 Nov 20;60(21):2230–2236.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

November 20, 2012

Volume

60

Issue

21

Start / End Page

2230 / 2236

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Prognosis
  • Population Surveillance
  • Peripheral Arterial Disease
  • Odds Ratio
  • Medicare
  • Male