Amputation risk up for Black, rural residents with diabetic foot ulcers

Amputation risk up for black, rural residents with diabetic foot ulcers

Rural patients identifying as Black have more than a 10 percent absolute increased risk for major leg amputation or death compared with the overall cohort of adult Medicare patients hospitalized with a diabetic foot ulcer, according to a study published online April 21 in JAMA Network Open.

Meghan B. Brennan, M.D., from the University of Wisconsin in Madison, and colleagues examined the associations of race, ethnicity, rurality, and/or neighborhood disadvantage with outcomes among U.S. patients with diabetic foot ulcers. The analysis included 124,487 patients hospitalized with diabetic foot ulcers (2013 to 2014) identified through the U.S. National Medicare Claims Data Database.

The researchers found that 17.6 percent of the cohort overall, 18.3 percent of rural patients, and 21.9 percent of Black patients underwent major leg amputation or died. This percentage reached 28.0 percent among rural patients identifying as Black, which exceeded the expected excess for rural patients (0.7 percent) plus those identifying as Black (4.3 percent) by more than twofold (10.4 versus 5.0 percent). A significant interaction between race and rurality remained high in adjusted predicted probability of major leg amputation or death (24.7 percent).

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