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Bias may explain disparity in leg amputations

Bias may explain disparity in leg amputations

Although differences in cultural preferences, wealth or access to top hospitals are blamed for many healthcare disparities, a new study concludes those are not the main reasons that blacks with poor leg circulation are almost twice as likely to be amputated as whites with the same condition.

“The main take home point of the article is that a large disparity exists between the treatment that white and non-white patients receive, and this disparity appears to go beyond simple differences in insurance status and other variables that are often cited as the cause,” wrote the study’s lead author Dr. Tyler Durazzo, from Yale University in New Haven, Connecticut, in an email to Reuters Health.

Durazzo and his colleagues, who published their findings in JAMA Surgery on Wednesday, write that previous studies found black patients with leg ischemia – poor blood flow – are more likely to have their legs amputated, compared to white patients, who are more likely to have so-called revascularization surgery to restore blood flow to save the limb.

The reasons behind this difference have been unclear. It could be that black patients lacked access to the same treatments as whites, or that black patients’ circulation problems are more severe by the time they seek help from a doctor, Durazzo’s team writes.

For the new study, the researchers explored possible explanations by examining data from 774,399 U.S. patients who were treated for leg ischemia from 2002 to 2008.

Overall, about 56 percent of black patients and 35 percent of white patients had an amputation.

There were some differences between the two groups. For example, black patients were more likely to also have diabetes and chronic kidney failure, and white patients were more likely to also have high blood pressure, chronic heart failure and lung disease.

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