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Association between Residential Distance from Home to Hospital and Amputation of a Lower Extremity among Peripheral Artery Disease Patients in Japan

Author

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  • Nobuko Hayashi

    (Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan)

  • Yusuke Matsuyama

    (Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan)

  • Takeo Fujiwara

    (Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo 113-8519, Japan)

Abstract

Lack of access to care can lead to poor outcomes for patients with peripheral artery disease (PAD). We investigated the association between residential distance from home to hospital and amputation of the lower extremity among PAD patients in the Chiba peninsula, Japan. A retrospective cohort study with an average follow-up period of 2.96 years was conducted using data from 630 PAD patients who visited two hospitals in the Chiba peninsula, Japan, between 1 April 2010 to 31 March 2020. Information on disease status, residential address, and covariates was obtained from medical records. The association between amputation of a lower extremity, including toe amputation, and residential distance was evaluated by Cox proportional hazards model. Age, gender, Fontaine class, endovascular treatment, dialysis, diabetes mellitus, hypertension, dyslipidemia, current or past smoking, and aspirin use were adjusted. The median residential distance was 18.9 km (interquartile range, IQR: 22.1). Ninety-two patients (14.6%) underwent amputation of the lower extremity during the follow-up period. The longer residential distance was significantly associated with a higher risk of lower extremity amputation (hazard ratio per IQR = 1.35, 95% confidence interval, 1.01–1.82) after adjusting for covariates. Poorer access to a hospital, assessed as a longer residential distance from home to a hospital, was associated with amputation of the lower extremity among PAD patients.

Suggested Citation

  • Nobuko Hayashi & Yusuke Matsuyama & Takeo Fujiwara, 2022. "Association between Residential Distance from Home to Hospital and Amputation of a Lower Extremity among Peripheral Artery Disease Patients in Japan," IJERPH, MDPI, vol. 19(20), pages 1-7, October.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:20:p:13088-:d:939562
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    References listed on IDEAS

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    1. Nemet, Gregory F. & Bailey, Adrian J., 2000. "Distance and health care utilization among the rural elderly," Social Science & Medicine, Elsevier, vol. 50(9), pages 1197-1208, May.
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