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The Relationship Between Peripheral Arterial Disease Severity and Socioeconomic Status
Kakra Hughes1, Olubode A Olufajo2, Kellee White3
1Department of Health Policy and Management, University of Maryland School of Public Health, College Park, MD; Department of Surgery, Howard University College of Medicine, Washington, DC.
Annals of Vascular Surgery
|February 3, 2023
Summary
Higher socioeconomic status is linked to more severe peripheral artery disease (PAD). However, patients with higher income underwent fewer amputations, revealing treatment disparities in severe PAD.
Area of Science:
- Vascular Surgery
- Health Services Research
- Socioeconomic Determinants of Health
Background:
- Socioeconomic disparities in peripheral artery disease (PAD) outcomes are known.
- The relationship between PAD severity and socioeconomic status (SES) is less understood.
Purpose of the Study:
- To investigate the association between socioeconomic status and the severity of peripheral artery disease.
- To identify disparities in treatment for severe PAD based on socioeconomic factors.
Main Methods:
- Analysis of 765,175 patients undergoing operations for severe PAD from the National Inpatient Sample (2005-2014).
- Stratification of patients by median household income (MHI) quartiles.
- Multivariable regression analyses to evaluate factors associated with disease severity and treatment, including amputations.
Main Results:
- Patients in the highest MHI quartile (fourth quartile) had a higher likelihood of severe PAD (OR: 1.19, 95% CI: 1.11-1.27) compared to the lowest MHI quartile (first quartile).
- Despite higher PAD severity, patients in the fourth MHI quartile were less likely to undergo amputations (25% vs. 34%).
- Patients in the fourth MHI quartile were more likely to be White and older (≥65 years).
Conclusions:
- Higher median household income is associated with increased peripheral artery disease severity.
- A significant disparity exists in amputation rates for severe PAD, with higher-income patients less likely to undergo this procedure.
- Efforts are needed to mitigate socioeconomic disparities in the management and treatment of severe PAD.
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