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Disparities among Patients Experiencing Homelessness Undergoing Open Lower Extremity Bypass.

Yijin Huang1, Samuel Nofsinger1, Chase Schesselman2

  • 1Division of Vascular Surgery, Department of Surgery, University of Missouri, School of Medicine, Columbia, MO.

Annals of Vascular Surgery
|October 17, 2025
PubMed
Summary
This summary is machine-generated.

Homeless patients undergoing lower extremity bypass (LEB) had significantly higher rates of amputation and 30-day readmission. These findings underscore the critical impact of housing instability on vascular surgery outcomes.

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Area of Science:

  • Vascular Surgery
  • Health Services Research
  • Socioeconomic Determinants of Health

Background:

  • The impact of homelessness on vascular surgery outcomes remains poorly understood.
  • Disparities in care and outcomes for homeless individuals undergoing major vascular procedures require investigation.

Purpose of the Study:

  • To investigate disparities in outcomes among homeless adults undergoing open lower extremity bypass (LEB).
  • To analyze the association between housing instability and key surgical outcomes.

Main Methods:

  • Retrospective review of the Nationwide Readmissions Database (2018-2020).
  • Identification of patients undergoing open LEB using ICD-10 codes, comparing those with and without housing instability.
  • Analysis of inpatient mortality, amputation rates, and 30-day readmission rates using multivariable logistic regression and statistical tests.

Main Results:

  • Homelessness was associated with increased odds of 30-day readmission (OR 1.8) and amputation (OR 2.4).
  • Homeless patients were younger, had greater disease severity, and experienced longer hospital stays with higher costs.
  • Surgical site infections were the primary cause for readmission in both groups.

Conclusions:

  • Homeless individuals undergoing LEB face substantially higher risks of amputation and readmission.
  • Housing status and socioeconomic factors significantly influence outcomes in vascular surgery patients.