Publications by authors named "N R Barshes"
Background: In 2011, the Veterans Health Administration (VHA) undertook multidisciplinary efforts to improve care for patients with nonhealing foot ulcers and reduce leg amputation rates. This article examines the impact of interdisciplinary care for amputation prevention in the VHA.
Methods: The VHA patient population was characterized using internal registries.
Objective: Wound, Ischemia, and foot Infection (WIfI) staging was established to provide objective classification in patients with chronic limb-threatening ischemia (CLTI) and to predict 1-year major amputation risk. Our goal was to validate WIfI staging using data from the Best Endovascular vs Best Surgical Therapy in Patients with CLTI (BEST-CLI) trial.
Methods: Data from the BEST-CLI Trial, a prospective randomized trial comparing surgical revascularization (OPEN) and endovascular revascularization (ENDO), were used to assess the association of WIfI stage on long-term outcomes in an intention-to-treat analysis.
Article Synopsis
- The study investigates racial and ethnic disparities in the use of forearm arteriovenous access (AVA) for hemodialysis initiation, finding that Black and Hispanic patients are less likely to have forearm AVAs compared to White patients.
- A retrospective analysis of over 70,000 patients from DaVita Kidney Care revealed a significant decline in the proportion of forearm AVA use, dropping from 49% in 2006 to 29% in 2019, without any differences in this trend among racial and ethnic groups.
- The results highlight persistent inequalities in AVA location choices among different races, suggesting a need for further research into the underlying factors contributing to these differences.
Medicaid coverage among patients with peripheral artery disease (PAD) has been associated with higher rates of primary amputations. We sought to determine the relative contributions of clinical, demographic, and hospital factors to leg amputations among Texas Medicaid patients. Patient-level data were used to identify patients who underwent treatment for PAD-related foot complications in Texas.
View Article and Find Full Text PDFIntroduction: The Society for Vascular Surgery Threatened Limb Classification System ('WIfI') is used to predict risk of limb loss and identify peripheral artery disease in patients with foot ulcers or gangrene. We estimated the diagnostic sensitivity of multiple clinical and noninvasive arterial parameters to identify chronic limb-threatening ischemia (CLTI).
Methods: We performed a single-center review of 100 consecutive patients who underwent angiography for foot gangrene or ulcers.