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Racial factors and inpatient outcomes among patients with diabetes hospitalized with foot ulcers and foot infections, 2003-2014

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  • Ché Matthew Harris
  • Aiham Albaeni
  • Roland J Thorpe
  • Keith C Norris
  • Marwan S Abougergi

Abstract

Background: In patients with diabetes, foot amputations among Black patients have been historically higher compared with White patients. Using the National Inpatient Sample database, we sought to determine if disparities in foot amputations and resource utilization have improved over time. We hypothesized there would be improvements and reduced differences in foot amputations between the two races as quality of care and access to healthcare has improved. Methods and findings: Patients over 18 years old with a principal diagnosis of diabetic foot complications and secondary diagnosis of Diabetes Mellitus were selected. We compared the primary outcome of foot amputations between Black and White patients. Adjusted rates, odds ratios (aOR) and trends of foot amputations among Black and White patients were studied. Healthcare utilization was measured via length of hospital stay (LOS). Of 262,924 patients, 18% were Black. Following adjustment for confounders, major foot amputations decreased among Whites (1.5% in 2003 to 1.1% in 2014) and Blacks (2.1% in 2003 to 0.9% in 2014). On pooled analysis, Black patients had higher adjusted odds of major foot amputations in 2003–2004 [aOR 1.7; (1.16–2.57), p

Suggested Citation

  • Ché Matthew Harris & Aiham Albaeni & Roland J Thorpe & Keith C Norris & Marwan S Abougergi, 2019. "Racial factors and inpatient outcomes among patients with diabetes hospitalized with foot ulcers and foot infections, 2003-2014," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-12, May.
    • Handle: RePEc:plo:pone00:0216832
    DOI: 10.1371/journal.pone.0216832
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    1. Barry I. Graubard & Edward L. Korn, 1999. "Predictive Margins with Survey Data," Biometrics, The International Biometric Society, vol. 55(2), pages 652-659, June.
    2. Grant H Skrepnek & Joseph L Mills Sr & David G Armstrong, 2015. "A Diabetic Emergency One Million Feet Long: Disparities and Burdens of Illness among Diabetic Foot Ulcer Cases within Emergency Departments in the United States, 2006–2010," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-15, August.
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