Girijala Raghavendra L, Bush Ruth L
Medical Education and Simulation, Texas A&M University, College Station, USA.
Surgery, University of Houston College of Medicine, Houston, USA.
Cureus. 2018 Oct 5;10(10):e3418. doi: 10.7759/cureus.3418.
Lower extremity amputation is one of the most unfortunate, yet preventable, consequences of uncontrolled lower limb ischemia occurring secondary to diabetes mellitus or peripheral arterial disease. In the United States, racial and socioeconomic disparities are associated with significant differences seen in the incidence and type or level of lower extremity amputation among patients. Due to shifting demographics and the uncertain state of healthcare coverage, lower extremity amputation rates are only projected to increase in the future. Given the potential societal and individual costs associated with the loss of a limb, this review seeks to summarize the recent findings on disparities in the identification, treatments offered, and outcomes of lower limb ischemia in order to elucidate potential interventions at the practitioner and policy levels.
下肢截肢是糖尿病或外周动脉疾病继发的下肢缺血未得到控制所导致的最不幸但又可预防的后果之一。在美国,种族和社会经济差异与患者下肢截肢的发生率、类型或水平方面的显著差异相关。由于人口结构的变化以及医保覆盖情况的不确定性,预计未来下肢截肢率只会上升。鉴于肢体缺失可能带来的社会和个人成本,本综述旨在总结下肢缺血在识别、治疗及预后方面差异的最新研究结果,以阐明在从业者和政策层面可能采取的干预措施。