Overview of In-Patient Burden of Lower Extremity Peripheral Artery Disease in Hispanics

Background: Hispanics have high rates of cardiovascular risk factors and prior data suggests that they undergo more amputations than non-Hispanic Whites (NHW) for peripheral artery disease (PAD). Little is known of treatment patterns and outcomes for this group in contemporary data. Thus, this study examined revascularizations, amputations, and mortality in Hispanics and NHW hospitalized with PAD. Methods: Data from the 2011-2017 National Inpatient Sample were used. Cross-sectional analysis of revascularizations and amputations were done by ethnicity using standardized differences ( d≥ 0.20 considered significant). Temporal trends in revascularizations and amputations by year were evaluated with the Cochran-Mantel-Haenszel test and stratified by ethnicity. Data were combined across years and multivariable logistic regression was used to evaluate the association of ethnicity with revascularization, amputation, and mortality, adjusting for risk factors. Results: From 2011-2017, 141,551 Hispanics were admitted with PAD (12-16% of annual admissions). Hispanics had higher rates of amputations (32% vs. 21%, d =0.31) and lower rates of revascularizations (43% vs. 60%, d =0.38) than NHW in the overall sample and over time (Fig. 1, all P trend <0.0001). Hispanic ethnicity was associated with lower odds of revascularization and mortality but higher odds of amputation (Fig. 2). Conclusion: A growing number of Hispanics are hospitalized for PAD. Despite an overall decline, amputations were more prevalent in Hispanics, suggesting that earlier systemic strategies for PAD awareness, diagnosis, and prevention are needed in Hispanic populations to eradicate this disparity.