Racial disparities in prosthesis abandonment and mobility outcomes after lower limb amputation from a dysvascular etiology in a veteran population.
Max Hurwitz, Joseph Czerniecki, David Morgenroth and 4 others
PMID 39099545WHAT IT FOUND
Overall prosthesis abandonment was low, but rural Black veterans abandoned their prostheses far more often than others.
Urban Black veterans were less likely to achieve advanced mobility. Depression strongly worsened these disparities in both groups.
Key findings
01Rural Black veterans had a significantly higher rate of prosthesis abandonment (33%) compared to rural White (9%) and Hispanic (0%) veterans.
02Black veterans living in rural areas with major depressive disorder had 15.8 times the odds of abandoning their prosthesis compared to other races.
03Urban Black veterans were significantly less likely to achieve advanced mobility compared to other races, regardless of depression status.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study relied on self-reported data for prosthesis abandonment and mobility, which may be subject to recall bias. The number of participants in minority groups, particularly Hispanic and 'Other' races, was small, limiting the precision of estimates for these groups. The study could not determine the specific reasons for abandonment or mobility limitations, only the associations with race and depression. Participants were all veterans with access to the Veterans Affairs healthcare system, so findings may not generalize to civilians with similar conditions.
Declared interests
The authors declared no conflicts of interest. The study was funded by the U.S. Department of Veterans Affairs.
The easy way to misread this
Do not conclude that race itself causes these disparities. The study shows an association, but the underlying drivers are likely systemic factors such as access to care, transportation barriers in rural areas, and the impact of depression on rehabilitation adherence.