Racial and ethnic amputation level disparities in veterans undergoing incident dysvascular lower extremity amputation.

The study cannot determine the underlying reasons for the observed disparities, such as access to care, disease severity, or implicit bias. The population is limited to veterans, which may not fully generalize to the civilian population, although the authors state it is largely similar. The number of women and individuals from racial/ethnic groups other than Black, Hispanic, and White was small, limiting subgroup analysis. The definition of Hispanic ethnicity combines diverse populations and does not specify race, which may mask heterogeneity. The analysis relied on existing database codes, so it could not control for all possible confounding factors or clinical nuances not captured in the records.

The study was supported by the Department of Veterans Affairs. The authors declare no conflicts of interest.

Do not interpret the higher odds of transfemoral amputation in Black and Hispanic veterans as evidence that these groups are inherently less suitable for limb salvage. The study identifies an association, particularly in the absence of prior revascularization for Black veterans, but does not establish causality or rule out differences in disease presentation, access to vascular interventions, or severity of peripheral artery disease.