The findings, reported in the September issue of the Archives of Physical Medicine and Rehabilitation, reveal that African Americans accounted for approximately 40 percent of the state's lower limb dysvascular amputations, or amputations required because of blood vessel disease. African-Americans also were more likely to have amputations at higher levels than whites, for example, while 34 percent of African-Americans underwent above knee amputations, only 27 percent of whites had the same procedure.
"Rising rates of lower limb amputations in the general population combined with disproportionately higher rates among African Americans are concerning and warrant further investigation into their underlying causes and consequences," says Timothy R. Dillingham, M.D., lead author of the study and associate professor in the Johns Hopkins' physical medicine and rehabilitation department. "We need to better understand the causes of racial differences in amputation rates and policy makers need to identify and promote public health initiatives that alleviate the excess risk of limb loss the among minority populations."
Dillingham and his team analyzed information on 27,149 Maryland hospital patients from 1986 to 1997 who required lower limb amputations due to vascular disease. Patients excluded from the study sample included those who had a lower limb amputation due to trauma, including fractures, crash and burn injuries, bone or soft tissue malignancy, or congenital anomalies.
Rates for dysvascular amputations increased from 41.4 per 100,000 in 1986 to 47.2 per 100,000 in 1997. For all levels of amputation, annual rates of amputation among African Americans were two to four times higher
Contact: John Lazarou
Johns Hopkins Medical Institutions