Racial disparities in patients with amputation in an acute care setting in the immediate postoperative period.

The study used records from one urban academic hospital. Almost all patients already had a PM&R consult. This may not apply to hospitals without easy access to rehabilitation consults or an IRF. It was a retrospective record review, not a randomized trial. It can show associations but not prove that consults, age, or race caused discharge or length of stay. The limited data set did not include disease severity, surgical complications, income, zip code, employment, marital status, functional status, or rehabilitation candidacy. These could influence discharge and stay. The authors grouped upper and lower extremity amputations and distal and proximal amputations together. They also could not determine laterality. Amputation level effects may be hidden. The sample had very small numbers in some racial groups, such as 3 American Indian or Alaska Native patients and 15 Asian patients. The authors report a small effect size (0.04). They say practical application is limited.

The authors declared no conflict of interest. Funding came from the Shirley Ryan Ability Lab Research Fund and the Shirley Ryan Ability Lab Externship Program.

Do not read the descriptive discharge rates as proof of a racial disparity in access to inpatient rehabilitation. The primary outcome was not significantly associated with race or ethnicity, and the study is a single-site retrospective record review without functional status, disease severity, or socioeconomic variables.