04:03 PM Abstract No. 20 Impact of race in limb salvage rates in critical limb ischemia patients undergoing below-knee interventions

Abstract

To evaluate impact of race in limb salvage rate of patients with critical limb ischemia undergoing below the knee revascularization interventions. A retrospective review of all patients who underwent below the knee arterial revascularization interventions between January 2012 and September 2018 was performed. Demographics such as age, sex, race and ethnicity were assessed with comorbidities including hypertension, diabetes, dyslipidemia and smoking status. Population was grouped in race and ethnicity (White, African American (AA) and Hispanic) according to patient self-identification and limb salvage rates for each group was evaluated. All below the knee interventions were reviewed for technical success rates defined as successful creation of inline flow to the wound. Follow up duration and limb salvage rates were determined for all cases. Comparison of each race and ethnicity group in terms of technical success and clinical outcome was made using Chi Square test with SPSS software. We identified 393 patients who underwent percutaneous arterial revascularization, 201 males and 192 females with mean age of 69.08 years (range 34-98). Mean follow up duration was 2.3 years (1 month to 5.8 years) Out of the total population, 365 patients (92.9%) had hypertension, 262 (66.7%) were diabetic, 246 (62.6%) had dyslipidemia and 271 (68.9%) had a less than 5-year without smoking history. Technical success rates in each group was also not statistically significant with 88.8 in AAs, 78.9% in Hispanics, and 89.7% in Whites) Limb salvage rates showed no significant difference (p-value 0.256) among the groups, AA (70.7%), Hispanic (84.2%) and White population (74.1%). In our study limb salvage rates in patients with critical limb ischemia undergoing below the knee interventions is not impacted by race or ethnicity in contrast to what was published in the literature. We believe existing publications claiming poorer outcomes in African American and Hispanic populations may have institutional and/or geographical biases and larger studies need to be conducted for more definitive conclusions.