Geographic and Socioeconomic Disparities in Major Lower Extremity Amputation Rates in Metropolitan Areas

<0. 001). In metropolitan areas, after adjusting for clinical comorbidities and demographics, every 10 000 lower median household income was associated with a 4. 4% (95% CI, 3. 9-4. 8) higher amputation rate, and a 10-point higher Distressed Communities Index score was associated with a 3. 8% (95% CI, 3. 4%-4. 2%) higher amputation rate; there was no association between the proportion of patients eligible for Medicaid and amputation rate. These findings were comparable to the associations identified across all ZIP codes. Conclusions In metropolitan areas, where most individuals undergoing lower extremity amputation live, markers of lower socioeconomic status and Black race were associated with higher rates of major lower extremity amputation. Development of community-based tools for peripheral artery disease diagnosis and management targeted to communities with high amputation rates in urban areas may help reduce inequities in peripheral artery disease outcomes.