PMID- 36958901
OWN - NLM
STAT- MEDLINE
DCOM- 20230822
LR  - 20230822
IS  - 1558-4518 (Electronic)
IS  - 0895-7967 (Linking)
VI  - 36
IP  - 1
DP  - 2023 Mar
TI  - The association of racial and ethnic disparities and frailty in geriatric 
      patients undergoing revascularization for peripheral artery disease.
PG  - 78-83
LID - S0895-7967(23)00002-9 [pii]
LID - 10.1053/j.semvascsurg.2023.01.003 [doi]
AB  - Frailty is defined as a state of decreased physiologic reserve contributing to 
      functional decline and adverse outcomes. Racial disparities in frail patients 
      have been described sparsely in the literature. We aimed to assess whether race 
      influences frailty status in geriatric patients undergoing revascularization for 
      peripheral artery disease (PAD) with chronic limb-threatening ischemia (CLTI). A 
      5-year analysis of the National Surgical Quality Improvement Program database 
      included all geriatric (65 years and older) patients who underwent 
      revascularization for lower extremity PAD with CLTI. The frailty index was 
      calculated using a 11-variable modified frailty index and a cutoff of 0.27 
      indicated frail status. The primary outcome was an association of race or 
      ethnicity with frailty status. We included 7,837 geriatric patients who underwent 
      a surgical procedure (open: 55.2%) for PAD with CLTI. Mean age of patients was 
      75.4 years, 63.8% were male, 24.1% (n = 1,889) were frail, and 21.8% (n = 1,710) 
      were African American (AA). Overall complication rate was 11.2% (n = 909) and 
      overall mortality rate was 1.9% (n = 148). AA patients were more likely to be 
      frail than White patients (29.6% v 23.9%; P = .03). AA and Hispanic patients were 
      more likely to have complications (P = .03 and P = .001) and require readmission 
      (P = .015 and P = .001) compared with White and non-Hispanic patients, 
      respectively. Frail AA and frail Hispanic patients were more likely to have 
      30-day complications and readmission compared with frail White and frail 
      non-Hispanic patients, respectively. Race and ethnicity influence frailty status 
      in geriatric patients with PAD and CLTI. These disparities exist regardless of 
      age, sex, comorbid conditions, and type of operative procedure. Additional 
      studies are needed to highlight disparities by race and ethnicity to identify 
      potentially modifiable risk factors to improve outcomes.
CI  - Published by Elsevier Inc.
FAU - Pandit, Viraj
AU  - Pandit V
AD  - Department of Surgery, Central California Veterans Health Care System, Fresno, 
      Surgical Service 112, 2615 E Clinton Avenue, Fresno, CA, 93703. Electronic 
      address: viraj.pandit@va.gov.
FAU - Brown, Taylor
AU  - Brown T
AD  - Washington State University, Seattle, WA.
FAU - Bhogadi, Sai Krishna
AU  - Bhogadi SK
AD  - Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of 
      Surgery, College of Medicine, University of Arizona, Tucson, AZ.
FAU - Kempe, Kelly
AU  - Kempe K
AD  - Division of Vascular Surgery, Department of Surgery, University of Oklahoma 
      School of Community Medicine, Tulsa, OK.
FAU - Zeeshan, Muhammad
AU  - Zeeshan M
AD  - Department of Surgery, Westchester Medical Center, Valhalla, NY.
FAU - Bikk, Andras
AU  - Bikk A
AD  - Department of Surgery, Central California Veterans Health Care System, Fresno, 
      Surgical Service 112, 2615 E Clinton Avenue, Fresno, CA, 93703.
FAU - Tan, Tze-Woei
AU  - Tan TW
AD  - Department of Vascular Surgery, University of Southern California, Los Angeles, 
      CA.
FAU - Nelson, Peter
AU  - Nelson P
AD  - Division of Vascular Surgery, Department of Surgery, University of Oklahoma 
      School of Community Medicine, Tulsa, OK.
LA  - eng
PT  - Journal Article
DEP - 20230125
PL  - United States
TA  - Semin Vasc Surg
JT  - Seminars in vascular surgery
JID - 8809602
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - Male
MH  - *Frail Elderly
MH  - *Frailty/diagnosis/complications
MH  - *Peripheral Arterial Disease/diagnosis/surgery
MH  - Postoperative Complications/etiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - *Vascular Surgical Procedures
OTO - NOTNLM
OT  - Disparities
OT  - Frailty
OT  - Peripheral artery disease
EDAT- 2023/03/24 06:00
MHDA- 2023/03/28 06:00
CRDT- 2023/03/23 21:59
PHST- 2022/11/06 00:00 [received]
PHST- 2023/01/10 00:00 [revised]
PHST- 2023/01/16 00:00 [accepted]
PHST- 2023/03/23 21:59 [entrez]
PHST- 2023/03/24 06:00 [pubmed]
PHST- 2023/03/28 06:00 [medline]
AID - S0895-7967(23)00002-9 [pii]
AID - 10.1053/j.semvascsurg.2023.01.003 [doi]
PST - ppublish
SO  - Semin Vasc Surg. 2023 Mar;36(1):78-83. doi: 10.1053/j.semvascsurg.2023.01.003. 
      Epub 2023 Jan 25.