Introduction: The goal of this study was to determine if disparities exist in the care of patients with lower extremity trauma (LET). We aimed to compare rate of limb salvage v. amputation for race, sex, age, and insurance... [ view full abstract ]
Introduction: The goal of this study was to determine if disparities exist in the care of patients with lower extremity trauma (LET). We aimed to compare rate of limb salvage v. amputation for race, sex, age, and insurance status. We hypothesized that there would be disparities in salvage v. amputation.
Methods: The institution trauma registry was used to identify patients admitted with LET from 2010-2014. ICD-9 codes were used to identify patients undergoing any amputation below the knee. Patient demographic, injury, and clinical variables were compared.
Results: There were 6902 patients with a LET, of which 131 patients underwent amputation. 105 were below knee amputations (p<0.0001). Patients undergoing amputation had significantly longer length of stay (p<0.0001) and were more likely to be male (p=0.0021). No difference was observed for age (p=0.9936), race (0.0666), or injury severity score (ISS) (p=0.1495). The time to seek care was significantly longer (p=0.0028). There was a significant difference (p<0.0001) in payment with a larger portion of those undergoing amputation having payment of other (7.63%) or workers’ compensation (9.92%).
Conclusion: There was no significant difference in amputation v. salvage by race, sex or ISS for patients with lower extremity trauma. Patients who underwent amputations had a longer length of stay and were more likely to be male. The results demonstrate that patients who had private insurance were more likely to receive limb salvage. Further investigations utilizing a multicenter, nationwide database should be performed to verify and validate these results.
