Hispanic Ethnicity and Vascular Access Use in Patients Initiating Hemodialysis in the United States

Background: Despite national vascular access guidelines promoting the use of arteriovenous fistulas (AVF) over arteriovenous grafts (AVGs) for dialysis, AVF use is substantially lower in females. We assessed clinically relevant AVF and AVG surgical outcomes in elderly male and female patients initiating hemodialysis with a central venous catheter (CVC). Methods: Using the United States Renal Data System standard analytic files linked with Medicare claims, we assessed incident hemodialysis patients in the United States, 9,458 elderly patients (≥67 years; 4,927 males and 4,531 females) initiating hemodialysis from July 2010 to June 2011 with a catheter and had an AVF or AVG placed within 6 months. We evaluated vascular access placement, successful use for dialysis, assisted use (requiring an intervention before successful use), abandonment after successful use, and rate of interventions after successful use. Results: Females were less likely than males to receive an AVF (adjusted likelihood 0.57, 95% CI 0.52–0.63). Among patients receiving an AVF, females had higher adjusted likelihoods of unsuccessful AVF use (hazard ratio [HR] 1.46, 95% CI 1.36–1.56), assisted AVF use (OR 1.34, 95% CI 1.17–1.54), and AVF abandonment (HR 1.28, 95% CI 1.10–1.50), but similar relative rate of AVF interventions after successful use (relative risk [RR] 1.01, 95% CI 0.94–1.08). Among patients receiving an AVG, females had a lower likelihood of unsuccessful AVG use (HR 0.83, 95% CI 0.73–0.94), similar rates of assisted AVG use (OR 1.05, 95% CI 0.78–1.40) and AVG abandonment, and greater relative rate of interventions after successful AVG use (RR 1.16, 95% CI 1.01–1.33). Conclusions: While AVFs should be considered the preferred vascular access in most circumstances, clinical AVF surgical outcomes are uniformly worse in females. Clinicians should also consider AVGs as a viable alternative in elderly female patients initiating hemodialysis with a CVC to avoid extended CVC dependence.

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Race, Hispanic Ethnicity, and the Future of the College Business Major in the United States

Journal of Education for Business ◽

10.1080/08832320109601312 ◽

2001 ◽

Vol 76 (4) ◽

pp. 209-215 ◽

Cited By ~ 8

Author(s):

Karen Leppel

Keyword(s):

United States ◽

The United States ◽

Hispanic Ethnicity ◽

The Future

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Abstract A83: Diversity by race, Hispanic ethnicity, and sex of the United States medical oncology physician workforce

10.1158/1538-7755.disp13-a83 ◽

2014 ◽

Author(s):

Ramon Burgos ◽

Christina H. Chapman ◽

Wei-Ting Hwang ◽

Stefan Both ◽

Charles R. Thomas ◽

...

Keyword(s):

United States ◽

Medical Oncology ◽

The United States ◽

Physician Workforce ◽

Hispanic Ethnicity

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Descriptive Epidemiology of Homicides With Victim and Suspect Race or Hispanic Ethnicity Discordance in the United States: Analysis of National Violent Death Reporting System (NVDRS) 2005-2015

Journal of Interpersonal Violence ◽

10.1177/0886260519861656 ◽

2019 ◽

pp. 088626051986165

Author(s):

Cara L. Frankenfeld ◽

Timothy F. Leslie

Keyword(s):

United States ◽

Race And Ethnicity ◽

Partner Violence ◽

Reporting System ◽

National Level ◽

The United States ◽

Romantic Partners ◽

Violent Death ◽

Hispanic Ethnicity ◽

Race Ethnicity

Cross-racial violence is a high-profile issue in the United States; however, there is little empirical research on the epidemiology of cross-racial homicides. The objective of this work was to use national-level data to evaluate the characteristics of homicides in which the victim and suspect are of the same or different race or Hispanic ethnicity. Victims and suspects from National Violent Death Reporting System data (2005-2015) were classified into seven-categories on the basis of race/ethnicity (six non-Hispanic races or Hispanic ethnicity), and 51,454 homicide events were classified as concordant (same race or ethnicity), discordant (different race or ethnicity), or unknown (missing race or ethnicity or no suspect information). While discordancy was observed to be similar across all race and ethnicity groups, it was less likely with relatives, romantic partners, and relatives of romantic partners; less likely to occur at home; less likely to occur in intimate partner violence–related homicides; less likely when the homicide was preceded by an argument over money or property; less likely when the homicide was associated with a family problem; more likely among rival gangs and strangers than other known person relationships; and more likely with drug-involved homicides. There were differences for victims of non-Hispanic Black race. Notably, discordance was more likely for justifiable self-defense and more likely with victim having used a weapon. These results suggest that discordant homicides may follow patterns of peer groups and close relationships in society regardless of victim race/ethnicity, that is, individuals may form closer relationships with individuals of the same race/ethnicity.

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A Social Space Approach to Testing Complex Hypotheses: The Case of Hispanic Marriage Patterns in the United States

Socius Sociological Research for a Dynamic World ◽

10.1177/2378023117739176 ◽

2017 ◽

Vol 3 ◽

pp. 237802311773917 ◽

Cited By ~ 1

Author(s):

Jeffrey A. Smith

Keyword(s):

United States ◽

Social Space ◽

The United States ◽

Theoretical Framework ◽

Social Categories ◽

Hispanic Ethnicity ◽

Marriage Patterns ◽

Past Work ◽

Formal Framework ◽

Complex Picture

Where do individuals identifying as Hispanic fit in the racial landscape of the United States? The answer offered by past work is complex: The empirical results do not lend themselves to simple interpretation as no single hypothesis fits the Hispanic case very well. Instead, Hispanic integration is described as mixtures of different archetypical hypotheses, like panethnic formation, white assimilation, and racialized assimilation. My goal is to develop a formal framework to help make sense of this complex picture. I extend past work by showing which combination of integration processes (panethnic formation, white assimilation, etc.) best characterizes Hispanic marriage patterns. I make two analytical contributions. First, I organize past Hispanic hypotheses, both archetypical and blended, into a single theoretical framework defined by the salience of race and Hispanic ethnicity. Second, I parametize this theoretical framework using latent social space models. In this way, I am able to specify a set of interconnected, complex hypotheses in a tractable manner. I follow past work and use marriage/cohabitation data to test the hypotheses. Using American Community Survey data (2010–2012), I find that Hispanic marriage/cohabitation patterns suggest high salience on both race and Hispanic ethnicity. Thus, categories like black-Mexican or white-Cuban represent relationally distinct social categories—distinct from both non-Hispanic racial categories (e.g., black or white) and Hispanic categories of a different racial identity.

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Geographical clustering of mortality from systemic lupus erythematosus in the United States: contributions of poverty, Hispanic ethnicity and solar radiation

Lupus ◽

10.1191/0961203306071455 ◽

2006 ◽

Vol 15 (10) ◽

pp. 662-670 ◽

Cited By ~ 25

Author(s):

S J Walsh ◽

A Gilchrist

Keyword(s):

United States ◽

Systemic Lupus Erythematosus ◽

Solar Radiation ◽

Lupus Erythematosus ◽

The United States ◽

Systemic Lupus ◽

Hispanic Ethnicity ◽

Geographical Clustering

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Vascular access use in Europe and the United States: Results from the DOPPS

Kidney International ◽

10.1046/j.1523-1755.2002.00117.x ◽

2002 ◽

Vol 61 (1) ◽

pp. 305-316 ◽

Cited By ~ 551

Author(s):

Ronald L. Pisoni ◽

Eric W. Young ◽

Dawn M. Dykstra ◽

Roger N. Greenwood ◽

Erwin Hecking ◽

...

Keyword(s):

United States ◽

Vascular Access ◽

The United States

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Gender differences in vascular access in hemodialysis patients in the United States: Developing strategies for improving access outcome

Gender Medicine ◽

10.1016/s1550-8579(07)80040-4 ◽

2007 ◽

Vol 4 (3) ◽

pp. 193-204 ◽

Cited By ~ 28

Author(s):

Richard J. Marcus ◽

Dawn A. Marcus ◽

Kalathil K. Sureshkumar ◽

Sabiha M. Hussain ◽

Rita L. McGill

Keyword(s):

United States ◽

Gender Differences ◽

Vascular Access ◽

The United States ◽

Hemodialysis Patients ◽

Developing Strategies

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Supply and Distribution of Vascular Access Physicians in the United States: A Cross-Sectional Study

Kidney360 ◽

10.34067/kid.0002722020 ◽

2020 ◽

Vol 1 (8) ◽

pp. 763-771

Author(s):

Shoou-Yih D. Lee ◽

Jie Xiang ◽

Abhijit V. Kshirsagar ◽

Diane Steffick ◽

Rajiv Saran ◽

...

Keyword(s):

United States ◽

Vascular Access ◽

Primary Care Physicians ◽

The United States ◽

Cross Sectional Study ◽

Bivariate Analysis ◽

Health Resource ◽

Surgical Specialty ◽

Cross Sectional ◽

Hospital Referral

BackgroundBecause functioning permanent vascular access (arteriovenous fistula [AVF] or arteriovenous graft [AVG]) is crucial for optimizing patient outcomes for those on hemodialysis, the supply of physicians placing vascular access is key. We investigated whether area-level demographic and healthcare market attributes were associated with the distribution and supply of AVF/AVG access physicians in the United States.MethodsA nationwide registry of physicians placing AVFs/AVGs in 2015 was created using data from the United States Renal Data System and the American Physician Association’s Physician Masterfile. We linked the registry information to the Area Health Resource File to assess the supply of AVF/AVG access physicians and their professional attributes by hospital referral region (HRR). Bivariate analysis and Poisson regression were performed to examine the relationship between AVF/AVG access physician supply and demographic, socioeconomic, and health resource conditions of HRRs. The setting included all 50 states. The main outcome was supply of AVF/AVG access physicians, defined as the number of physicians performing AVF and/or AVG placement per 1000 prevalent patients with ESKD.ResultsThe majority of vascular access physicians were aged 45–64 (average age, 51.6), male (91%), trained in the United States (76%), and registered in a surgical specialty (74%). The supply of physicians varied substantially across HRRs. The supply was higher in HRRs with a higher percentage white population (β=0.44; SEM=0.14; P=0.002), lower unemployment rates (β=−10.74; SEM=3.41; P=0.002), and greater supply of primary care physicians (β=0.18; SEM=0.05; P=0.001) and nephrologists (β=15.89; SEM=1.22; P<0.001).ConclusionsGeographic variation was observed in the supply of vascular access physicians. Higher supply of such specialist physicians in socially and economically advantaged areas may explain disparities in vascular access and outcomes in the United States and should be the subject of further study and improvement.

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