PMID- 32628994
OWN - NLM
STAT- MEDLINE
DCOM- 20210118
LR  - 20210118
IS  - 1615-5947 (Electronic)
IS  - 0890-5096 (Linking)
VI  - 70
DP  - 2021 Jan
TI  - Living in a Food Desert is Associated with 30-day Readmission after 
      Revascularization for Chronic Limb-Threatening Ischemia.
PG  - 36-42
LID - S0890-5096(20)30553-7 [pii]
LID - 10.1016/j.avsg.2020.06.052 [doi]
AB  - BACKGROUND: Living in a food desert has been associated with increased 
      cardiovascular risk; however, its impact on vascular surgery outcomes is unknown. 
      This study hypothesized that living in a food desert would be associated with 
      increased postoperative complications in patients undergoing revascularization 
      for chronic limb-threatening ischemia (CLTI). METHODS: This was a single-center 
      retrospective analysis of open and endovascular infrainguinal revascularization 
      for CLTI between April 2013 and December 2015. A food desert was defined using 
      the US Department of Agriculture's Food Access Research Atlas. Bivariate analyses 
      were performed appropriate to the data. Binary logistic regression was performed 
      assessing the association of food desert status with 30-day postoperative 
      complications. RESULTS: In total, 152 cases were included, of which 17% (n = 26) 
      resided in food deserts. Patients in the food desert cohort were less likely to 
      be low income (27% vs. 54%, P = 0.01). Living in a food desert was associated 
      with increased 30-day readmission [(39% vs. 20%, P = 0.04), unadjusted OR: 2.5 
      (CI: 1.0-6.2)]. FD cases also had a higher proportion of wound complications [12 
      (46%) vs. 28 (22%), P = 0.01)]. The overall wound complication rate was 27% with 
      the majority being due to infections (63%). On multivariable analysis, food 
      desert status remained associated with increased odds of 30-day readmission (OR: 
      2.7, CI: 1.2-8.4, P = 0.047). Reasons for readmission in the food desert group 
      were all due to wound complications (100% vs. 72%, P = 0.08). CONCLUSIONS: Living 
      in a food desert was associated with nearly three times the odds of 30-day 
      readmission after lower extremity revascularization for CLTI. This increase in 
      readmission may be explained through increased wound complications. These 
      findings support considering access to healthy food as a potential modifiable 
      risk factor for adverse outcomes, particularly in CLTI revascularization.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Smith, Eric J T
AU  - Smith EJT
AD  - Department of Surgery, University of California, San Francisco, CA.
FAU - Ramirez, Joel L
AU  - Ramirez JL
AD  - Department of Surgery, University of California, San Francisco, CA.
FAU - Wu, Bian
AU  - Wu B
AD  - Department of Surgery, University of California, San Francisco, CA.
FAU - Zarkowsky, Devin S
AU  - Zarkowsky DS
AD  - Department of Surgery, University of California, San Francisco, CA.
FAU - Gasper, Warren J
AU  - Gasper WJ
AD  - Department of Surgery, University of California, San Francisco, CA.
FAU - Finlayson, Emily
AU  - Finlayson E
AD  - Department of Surgery, University of California, San Francisco, CA.
FAU - Conte, Michael S
AU  - Conte MS
AD  - Department of Surgery, University of California, San Francisco, CA.
FAU - Iannuzzi, James C
AU  - Iannuzzi JC
AD  - Department of Surgery, University of California, San Francisco, CA. Electronic 
      address: james.iannuzzi@ucsf.edu.
LA  - eng
PT  - Journal Article
DEP - 20200703
PL  - Netherlands
TA  - Ann Vasc Surg
JT  - Annals of vascular surgery
JID - 8703941
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Disease
MH  - Female
MH  - *Food Deserts
MH  - Humans
MH  - Ischemia/diagnosis/epidemiology/*surgery
MH  - Male
MH  - Middle Aged
MH  - *Patient Readmission
MH  - Peripheral Arterial Disease/diagnosis/epidemiology/*surgery
MH  - Postoperative Complications/diagnosis/*epidemiology/therapy
MH  - *Residence Characteristics
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
MH  - Urban Health
MH  - Vascular Surgical Procedures/*adverse effects
MH  - Wound Healing
EDAT- 2020/07/07 06:00
MHDA- 2021/01/20 06:00
CRDT- 2020/07/07 06:00
PHST- 2020/03/22 00:00 [received]
PHST- 2020/06/30 00:00 [revised]
PHST- 2020/06/30 00:00 [accepted]
PHST- 2020/07/07 06:00 [pubmed]
PHST- 2021/01/20 06:00 [medline]
PHST- 2020/07/07 06:00 [entrez]
AID - S0890-5096(20)30553-7 [pii]
AID - 10.1016/j.avsg.2020.06.052 [doi]
PST - ppublish
SO  - Ann Vasc Surg. 2021 Jan;70:36-42. doi: 10.1016/j.avsg.2020.06.052. Epub 2020 Jul 
      3.