Orthopedic Surgery Referral Pattern Analysis per Demographic Factors Among Patients Diagnosed With Severe Peripheral Artery Disease in Terms of Partial or Total Limb Amputation

Abstract

Introduction: Peripheral artery disease (PAD) signifies the obstruction of blood vessels in the lower extremities due to harmful buildup of fatty material. Patients may present to their primary care provider complaining of lower extremity pain, especially during exercise. Primary care providers must weigh the severity of patients' disease process to determine if an orthopedic surgery referral is needed based on an extensive history as well as analysis of demographic factors that may influence their risk of morbidity and mortality. We aimed to objectively present these demographic factors with numeric values in terms of influence.Methods: We utilized the Cerner Health Facts database to analyze 63 million unique patient encounters from 2000 to 2018. The database is categorized as Institutional Review Board (IRB) exempt due to its de-identified presentation. In an outcome-based approach, we were able to calculate referral patterns based on entered demographic parameters.Results: A patient's age, census region, marital status, previous history of PAD/critical limb ischemia (CLI), history of surgeries, race, facility type, and urban/rural status presented as predictors of seeing a surgeon during a patient encounter. Conclusion: Our results found numerous aforementioned demographic factors to be associated with orthopedic surgery referral patterns. This is significant as proper reconciliation of these factors may help reduce patient morbidity in terms of amputation reduction and reduce patient mortality associated with this surgery or complications.