Outcome of Femoral-popliteal Bypass Procedures in Different Ethnic Groups in England: A Retrospective Analysis of Hospital Episode Statistics

Vitalis, Antonios, Shantsila, Alena ORCID: 0000-0002-0594-8576, Kay, Mark, Vohra, Rajiv K and Lip, Gregory YH (2021) Outcome of Femoral-popliteal Bypass Procedures in Different Ethnic Groups in England: A Retrospective Analysis of Hospital Episode Statistics. ANNALS OF VASCULAR SURGERY, 76. pp. 351-356.

Text HES bypass operations_clean docx_.docx - Author Accepted Manuscript Download (79kB)

Abstract

<h4>Background</h4>Previous studies, mainly from the United States, have reported worse outcomes from lower limb bypass procedures in ethnic minority populations. Limited nationwide data are available from ethnic minority populations from Europe. The aim of this study is to investigate outcomes from lower limb bypass procedures in ethnic minorities from England.<h4>Methods</h4>We enquired the "Hospital Episode Statistics" database, using ICD-10 codes to identify all cases of femoral-popliteal bypass operations from English NHS Hospitals from 01/01/2006 to 31/12/2015. Every case was followed up for 2 years for subsequent events. The primary outcomes were mortality and major leg amputation. Patients were broadly categorised according to Black, Asian and White ethnicity. Chi-square test was used to the ethnic groups and odds ratios (OR) were calculated using White ethnic group with the largest numbers of participants as a reference category.<h4>Results</h4>In the examined 10-year period, 20825 femoral-popliteal bypass procedures (250 of Black, 167 of Asian, and 20.408 of White ethnicity) were recorded. Thirty-day and 2-year mortality were 2.8% and 16.8% with no significant ethnic differences. Patients of Black ethnicity had higher risk of limb loss compared to Whites (23.2% vs. 15.6%, OR = 1.63, 95% confidence interval (CI) 1.21-2.19, P < 0.01). There was no significant difference in amputation rates between Asians and Whites (16.2% vs.. 15.6%, P = 0.94).<h4>Conclusions</h4>Patients of Black ethnicity are at higher risk of limb loss after a femoropopliteal bypass procedure. Further research is needed to identify the causes of this discrepancy.

Item Type:	Article
Uncontrolled Keywords:	Lower Extremity, Humans, Treatment Outcome, Limb Salvage, Risk Assessment, Risk Factors, Retrospective Studies, Time Factors, Aged, Aged, 80 and over, Middle Aged, Hospitals, State Medicine, England, Female, Male, Health Status Disparities, Vascular Grafting, Peripheral Arterial Disease, Race Factors, Ethnic and Racial Minorities, Amputation, Surgical, Asian People, White People, Black People
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	30 Jun 2021 13:40
Last Modified:	16 Feb 2023 00:37
DOI:	10.1016/j.avsg.2021.04.018
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3128278