Table 2.

Amputation rates among different minority and ethnic groups

Study	Author(s)	Population	Level of amputation	Increased rate of amputation among minority race and ethnicity
Variation in the incidence and proportion of diabetes-related amputations in minorities	Lavery et al. (1996) [29]	8169 hospitalizations for LEA in African Americans, Hispanics, and non-Hispanic White	More proximal amputations were seen in African Americans compared to Hispanic and non-Hispanic White people (p < 0.001)	More amputations in African American people (61.6%) and Hispanic people (82.7%) than in non-Hispanic White people (56.8%) (p < 0.001)
Diabetes mellitus and nontraumatic lower extremity amputation in black and White Americans: the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, 1971–1992	Resnick et al. (1999) [32]	14,407 subjects in the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study	Locations of LEAs were distributed similarly between White and Black participants	Black participants with diabetes were more likely to receive LEAs than White participants but the difference is only significant for incidence of diabetes mellitus and not prevalence of diabetes mellitus (3.4% vs. 1.4%, p = 0.02)
Effects of ethnicity and nephropathy on lower-extremity amputation risk among diabetic veterans	Young et al. (2003) [33]	3289 individuals had an LEA within the U.S. Veterans Affairs (VA) Health Care System during 1998	Asian participants were more likely to receive toe amputations than White and other participants; Native American participants were more likely to receive BKAs	Native American participants (RR 1.74, 95% CI 1.39–2.18), followed by Black (RR 1.41, 95% CI 1.34–1.48) and Hispanic participants (RR 1.28, 95% CI 1.20–1.38), had the highest risk of LEA compared with White participants
Racial differences in primary and repeat amputation: a multihospital study	Feinglass et al. (2005) [34]	513 patients with 71% undergoing a major amputation	African American people without diabetes have greater racial and ethnic differences in amputation level than those among patients with diabetes	65.9% of African American patients with diabetes (OR 1.69, 95% CI 1.11–2.56) compared to 53.1% White or other-race patients underwent primary amputations
Association between race/ethnicity and the risk of amputation of lower extremities among Medicare beneficiaries with diabetic foot ulcers and diabetic foot infections	Tan et al. (2020) [35•]	92,929 Medicare beneficiaries diagnosed with DFUs and/or DFIs	Not mentioned	Black (HR 1.9, 95% CI 1.7–2.2) and Native American (HR 1.8, 95% CI 1.3–2.6) beneficiaries were at an increased risk of major amputation compared to White beneficiaries
Racial, rural, and regional disparities in diabetes-related lower-extremity amputation rates, 2009–2017	Akinlotan et al. (2021) [36•]	112,713 patients with diabetes-related discharges in the US had a minor or major LEA	Native Americans were more likely to have a minor (toe and foot) amputation compared with White (OR 1.26; 95% CI 1.167–1.36)	Black (OR 1.12, 95% CI 1.08–1.16), Hispanic (OR 1.24, 95% CI 1.19–1.29), and Native American (OR 1.32, 95% CI 1.16–1.50) patients were more likely to experience a major amputation compared with White
Racial disparities in health care with timing to amputation following diabetic foot ulcer	Miller et al. (2022) [25••]	68,633 Medicare fee-for-service beneficiaries with a DFU who experienced a LEA within the 5-year study time	Not mentioned	There was an increase in the proportion of Black/African American individuals who received an LEA after DFU; they are more likely to have an amputation within the first year after a DFU compared to non-Hispanic White individuals (OR 2.18, 95% CI 2.13–2.23)

LEA, lower extremity amputation; OR, odds ratio; CI, confidence interval; DFU, diabetic foot ulcer; DFI, diabetic foot infection; HR, hazard ratio