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Unhoused PAD patients face a much steeper road to recovery. A new retrospective study found that patients with recurrent homelessness had a 2.3 times greater risk of major amputation after lower-extremity revascularization compared to housed patients. Experts say targeted screening, care coordination, and medical respite programs are key to closing this gap.
A large retrospective study using data from the Society for Vascular Surgery National Vascular Quality Initiative (2009–2025) reveals that housing instability significantly worsens outcomes for patients with peripheral artery disease (PAD). Patients experiencing recurrent homelessness faced a 2.3 times greater risk of major amputation after lower-extremity revascularization compared to stably housed patients — even after controlling for clinical severity.
The findings highlight that homelessness isn't a one-size-fits-all risk factor. Patients with recurrent homelessness were more likely to be younger, male, nonwhite, and on Medicaid or self-pay, and had higher rates of chronic limb-threatening ischemia (88%) and emergent procedures — pointing to a compounding cycle of social and clinical vulnerability.
By the Numbers
Why it matters: Researchers and clinicians are calling for recurrent homelessness to be recognized as an independent risk factor, prompting targeted screening, care coordination, and medical respite programs — such as hospital-shelter partnerships — to prevent patients from falling through the cracks post-surgery.
