Journal of Vascular Surgery最新文献

{"title":"Utilization of Large-Scale Electronic Health Record Database to Understand Social Determinants of Health Disparities in the Diabetic Patient Population with Major Lower Limb Amputation.","authors":"Yiming Zhang, Tammy T Nguyen","doi":"10.1016/j.jvs.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.jvs.2025.09.022","url":null,"abstract":"<p><strong>Objective: </strong>Poorly controlled diabetes is associated with higher risks of lower extremity amputations (LEAs). Social determinants of health, alternatively termed social drivers of health (SDoH), have been shown to play an important role in health outcomes. However, specific SDoH domains that impact poorly controlled diabetics (PC-diabetics) are undefined. This study aims to utilize Epic Cosmos, a cross-institutional electronic medical record (EHR) database, to identify these specific social risk factors in order to better inform and tailor support services.</p><p><strong>Methods: </strong>Epic Cosmos is a HIPAA-compliant data platform with longitudinal EHR records of more than 300 million patients. PC-diabetics were queried based on having at least one A1c test ≥ 7.0%, and non-diabetic or controlled diabetic patients (N/C-diabetic) were identified as having an A1c test < 7.0% and none above 7.0% from 2014 to 2018. LEAs within 5 years of the A1c test were identified through selected CPT codes (27590, 27591, 27592, 27594, 27880, 27881, 27882, 27884). SDoH diagnoses specific to this patient cohort were extracted using ICD-10-CM Z-codes (Z55 - Z75). All statistical significance was calculated using Chi-square tests in Microsoft Excel and R Studio, with significant level set at p = 0.05.</p><p><strong>Results: </strong>Our study included 4,512,612 PC-diabetic and 13,659,422 N/C-diabetic patients. The PC-diabetic cohort had 20,944 individuals with LEA while the N/C-diabetic group had 7,981 patients with LEA. In PC-diabetics with LEA, 28.41% had at least 1 SDoH diagnosis, in contrast to 12.20% of PC-diabetics without LEA or 11.80% of N/C-diabetics (p < 0.05). Patients with PC-diabetes and LEA are 3.02 times more likely to have problems related to housing/economic circumstances (Z59) and 2.54 times more likely to have problems related to lifestyle (Z72), compared to PC-diabetics without LEA. Our study also found high rates of smoking (Z72.0, 20.85% of total) in PC-diabetics with LEA. Moreover, African American PC-diabetics without LEA have higher baseline rates of SDoH diagnoses (14.90%) than their white/Caucasian counterpart (11.92%, p < 0.05).</p><p><strong>Conclusions: </strong>Our analysis on PC-diabetics with LEA showed higher SDoH diagnosis rates in housing/economic and lifestyle challenges compared to PC-diabetics without LEA. Tobacco use was found to be a particularly notable risk factor among this patient cohort. This study demonstrates the feasibility of using large-scale EHR databases to generate hypotheses and guide future strategies to address SDoH risk factors.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical effectiveness of drug eluting technologies for femoropopliteal disease","authors":"Michael S. Conte MD, DFSVS","doi":"10.1016/j.jvs.2025.03.475","DOIUrl":"10.1016/j.jvs.2025.03.475","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 4","pages":"Pages 1332-1333"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic Aortic Traumas: Tevar vs Open Operations: A Retrospective Review","authors":"Marie-Lyne Bourque ,&nbsp;Guillaume Febrer ,&nbsp;Fanny Lange ,&nbsp;Eric Couturier ,&nbsp;William Fortin","doi":"10.1016/j.jvs.2025.06.055","DOIUrl":"10.1016/j.jvs.2025.06.055","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 4","pages":"Pages e115-e116"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ticagrelor in Place of Clopidogrel: Time for Antiplatelet Paradigm Shift in Peripheral Artery Disease Management","authors":"Mounika Naidu Boya,&nbsp;Isabella Cieri,&nbsp;Adriana Rodriguez Alvarez,&nbsp;Shiv Patel,&nbsp;Anahita Dua","doi":"10.1016/j.jvs.2025.06.107","DOIUrl":"10.1016/j.jvs.2025.06.107","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 4","pages":"Page e112"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Amaurosis Fugax: Contemporary Outcomes of Patients With Transient Monocular Blindness","authors":"Jesse A. Columbo ,&nbsp;Pablo Martinez-Camblor ,&nbsp;Caitlin W. Hicks ,&nbsp;Bjoern D. Suckow ,&nbsp;Thomas S. Huber ,&nbsp;Samir Shah ,&nbsp;Salvatore T. Scali ,&nbsp;David H. Stone","doi":"10.1016/j.jvs.2025.06.098","DOIUrl":"10.1016/j.jvs.2025.06.098","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 4","pages":"Pages e106-e107"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrated Prosthetic Care Program Is Associated With Improved Prosthesis Receipt and Ambulation After Major Amputation","authors":"Randall A. Bloch,&nbsp;Elisa Caron,&nbsp;Scott G. Prushik,&nbsp;Katie E. Shean,&nbsp;Mark F. Conrad","doi":"10.1016/j.jvs.2025.06.104","DOIUrl":"10.1016/j.jvs.2025.06.104","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 4","pages":"Page e110"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A team sport","authors":"Michael C. Stoner MD","doi":"10.1016/j.jvs.2025.06.002","DOIUrl":"10.1016/j.jvs.2025.06.002","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 4","pages":"Page 1502"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular Regenerative Cell Exhaustion in Adults With Peripheral Artery Disease","authors":"Jack H. Casey ,&nbsp;Michael Moroney ,&nbsp;Aishwarya Krishnaraj ,&nbsp;Yi Pan ,&nbsp;Fallon Dennis ,&nbsp;Arianna Z. He ,&nbsp;Brady Park ,&nbsp;Raj Verma ,&nbsp;Hwee Teoh ,&nbsp;Adrian Quan ,&nbsp;Mohamad A. Hussain ,&nbsp;Graham Roche-Nagle ,&nbsp;Ger Curley ,&nbsp;David A. Hess ,&nbsp;Subodh Verma","doi":"10.1016/j.jvs.2025.06.090","DOIUrl":"10.1016/j.jvs.2025.06.090","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 4","pages":"Pages e102-e103"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term Outcomes Following Thoracic Branch Endoprosthesis: A Retrospective Cohort","authors":"Halli Krzyzaniak ,&nbsp;Mark Rockley ,&nbsp;Eric Herget ,&nbsp;Holly Smith ,&nbsp;Scott McClure ,&nbsp;Randy Moore ,&nbsp;Kenton Rommens","doi":"10.1016/j.jvs.2025.06.061","DOIUrl":"10.1016/j.jvs.2025.06.061","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 4","pages":"Pages e118-e119"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel EVAR Quality Metric Discriminates Center Performance and Predicts Future Outcomes","authors":"Douglas W. Jones ,&nbsp;Salvatore T. Scali ,&nbsp;Xinyan Zheng ,&nbsp;Jialin Mao ,&nbsp;Jessica Simons ,&nbsp;Marc Schermerhorn ,&nbsp;Andres Schanzer","doi":"10.1016/j.jvs.2025.06.101","DOIUrl":"10.1016/j.jvs.2025.06.101","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"82 4","pages":"Pages e108-e109"},"PeriodicalIF":3.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}