The outcomes of lower extremity revascularization: What role do race, ethnicity, and socioeconomic status play?
Semin Vasc Surg
; 36(1): 69-77, 2023 Mar.
Article
em En
| MEDLINE
| ID: mdl-36958900
ABSTRACT
Lower extremity peripheral artery disease and the resultant complications disproportionately affect underrepresented racial and ethnic minority groups, as well as those with low socioeconomic status (SES). Revascularization, including both open surgical and endovascular techniques, is a mainstay of therapy for symptomatic peripheral artery disease; it is required to maximize limb salvage in chronic limb-threatening ischemia and used to improve function and quality of life in patients with claudication. The outcomes of lower extremity revascularization in Black and Hispanic patients, as well as patients with low SES, are not widely known and this knowledge gap formed the basis for this review. The preponderance of evidence suggests that Black, Hispanic, and low-SES patients have inferior limb-related outcomes after revascularization compared with White patients. Based solely on the limited published evidence in the revascularization literature, the specific reasons for these disparities are not clear. The high prevalence of comorbidities and risks factors, as well as the advanced presentation of peripheral artery disease in Black, Hispanic, and low-SES patients, appear to contribute to the inferior limb outcomes post revascularization seen in these groups, but do not account for all of the disparities. Undoubtedly, a complex interplay of social determinants underlies these disparities in care and outcomes at individual, community, and societal levels. Additional understanding of the underpinnings and mechanisms of inferior outcomes in these populations in the specific context of lower extremity revascularization is needed, as this would allow us to identify targets for intervention to improve post-revascularization outcomes in these at-risk populations.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença Arterial Periférica
/
Procedimentos Endovasculares
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Grupos Minoritários
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
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Patient_preference
Limite:
Humans
Idioma:
En
Revista:
Semin Vasc Surg
Ano de publicação:
2023
Tipo de documento:
Article