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Race Independently Impacts Outcome of Infrapopliteal Bypass for Symptomatic Arterial Insufficiency

Department of Surgery, Division of Vascular Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, vrowe{at}surgery.usc.edu

S. Ram Kumar, MD, PhD

Department of Surgery, Division of Vascular Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California

Holly Glass

Department of Surgery, Division of Vascular Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California

Douglas B. Hood, MD

Department of Surgery, Division of Vascular Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California

Fred A. Weaver, MD, MMM

Department of Surgery, Division of Vascular Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California

The impact of racial background on the outcome of lower extremity revascularization is unknown because a majority of studies have a preponderance of white patients. The charts of patients between 1988 and 2004 requiring infrapopliteal lower extremity revascularization were reviewed. Life-table analyses, the Cox proportional hazards model, and log-rank test were used to calculate graft patency and limb salvage. Bypasses were performed on 236 limbs in 225 patients. Mean follow-up was 18 ± 1.5 months. Twenty-eight (12%) bypasses were performed on whites, 43 (18%) on African Americans, 148 (63%) on Hispanics, and 17 (7.2%) on patients of other races. African American race negatively correlated with primary-assisted patency (hazard ratio 2.9, P = .03), secondary patency (hazard ratio 3.64, P = .02), and limb salvage (hazard ratio 8, P = .006) compared with whites. African American race has a negative impact on the long-term outcome of infrapopliteal revascularization, regardless of disease stage or associated risk factors.

Key Words: race • limb salvage • bypass • peripheral arterial disease • lower extremity

Vascular and Endovascular Surgery, Vol. 41, No. 5, 397-401 (2007)
DOI: 10.1177/1538574407303679


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