b'Scientific Session Abstracts SATURDAY APRIL 20, 2024 1: RELATIONSHIP OF AREA DEPRIVATION INDEX TO PRESENTATIONS AND OUTCOMES AMONG CRITICAL LIMB THREATENING ISCHEMIA PATIENTS PRESENTING FOR MAJOR AMPUTATIONA VASCULAR QUALITY INITIATIVERaquel Wolfe, Alexander Schurman, Curti-Oborsky, Allison-Aipa, Jaclyn Corso, Kristyn Mannoia, Afshin Molkara, Paul Albini, Beatriz LeongRiverside University Health SystemObjectives: Social and environmental factors severely impact cardiovascular disease. Vascular surgeons aim to mitigate risk factors and offer revascularization to delay or prevent lower extremity amputation s, which also significantly impact a patients longevity and quality of life. The facets of social determinants of health may be represented as social vulnerability, a calculated aggregate of public data based on income, education, employment, and housing quality. The area deprivation index (ADI) groups individuals to depict communities more accurately than prior measurements of social vulnerability. We aim to utilize ADI and measure its relationship to revascularization attempts as well as amputation levels among patients with critical limb threatening ischemia.Methods: The Vascular Quality Initiatives (VQI) amputation database was queried from 2015 to 2019. Patients were grouped into quartiles by their ADI value to compare level of amputation and prior revascularization attempts via univariate analysis. Multivariate logistic regression models isolated the impact of ADI.Results: The VQI amputation database yielded 22,435 entries. Patients who are more socially vulnerable (ADIs top quartile), were younger and more likely to present with severe ischemia (31.4% v 26.7%, p 0.001). Patients in the top ADI quartile had a higher rate of above knee amputations compared to the lowest ADI quartile (45.4% v. 33%, p 0.001). Compared to the lowest ADI quartile, a larger proportion of top quartile ADI patients were not revascularized prior to amputation (54.7 % v 52.3 %, p =0.028). Top quartile ADI patients had higher rates of multi-segment revascularization for aortoiliac disease than lowest quartile ADI patients (7.5% v. 3.4%, OR 2.28; p 0.001). Aortoiliac peripheral vascular interventions were also more common in top quartile ADI patients (10.5% v. 6.9%, OR 1.69; p 0.001). Infrainguinal bypass attempts did n ot differ between ADI quartiles (18.2% v. 18.1%) however infrainguinal peripheral vascular interventions were offered to high quartile ADI participants at a lower rate (27.7%) compared to those who were less socially vulnerable (35.5%, OR 0.71; p 0.001).34SOUTHERN CALIFORNIA VASCULAR SURGICAL SOCIETY'