The Road To and Beyond Amputation: Outcomes of Major Limb Amputations In Vascular Surgery Department of Tertiary Care Hospital
DOI:
https://doi.org/10.51253/pafmj.v76i5.9636Keywords:
Acute Kidney Injury, Amputation, Cerebrovascular Accident, Limb ischemia, StrokeAbstract
Objective: To analyze the etiologies and outcomes for major limb amputations in patients presenting in a vascular surgery department.
Study Design: Observational study.
Place and Duration of Study: Department of Vascular Surgery, Combined Military Hospital, Lahore, Pakistan, from Jan to Dec 2021.
Methodology: Non-probability convenient sampling technique was used. Patients of either gender who had major limb amputations within the study period were included. Data were partially collected from patient files in our records. The patient's current status and data confirmation were done via telephone. Variables including gender, type of amputation, site of amputation, cause of amputation, comorbidities, survival, causes of death, side of amputation, prosthesis, other amputations, revision of procedure, position of limb, and procedure-related complications were presented as frequencies and percentages. Quantitative variables, including age, were presented as mean and standard deviation.
Results: A sample of 97 patients was included in the current study; 23 were lost to follow-up. There were 12.4% females and 87.6% males. The mean age of the cases was 55.26±9.77 (age range 27-72 years). The major cause of amputation was acute limb ischemia. 29.0% of patients died within 3 months of the procedure. The major cause of death was MI (36.0%) and the majority of patients died within 40 days of the procedure 18(64.0%). ......
Conclusion: Acute and chronic limb ischemia along with diabetic foot infections constitute the major causes of amputation in a vascular surgery unit. Mortality is high, especially in the postoperative period, in this population, with cardiovascular disease constituting the ............
Downloads
References
1. Barnes JA, Eid MA, Creager MA, Goodney PP. Epidemiology and risk of amputation in patients with diabetes mellitus and peripheral artery disease. Arterioscler Thromb Vasc Biol 2020; 40(8): 1808-1817.
https://doi.org/10.1161/ATVBAHA.120.314595
2. Delesalle G, Bohbot Y, Rusinaru D, Delpierre Q, Maréchaux S, Tribouilloy C. Characteristics and prognosis of patients with moderate aortic stenosis and preserved left ventricular ejection fraction. J Am Heart Assoc 2019; 8(6): e011036.
https://doi.org/10.1161/JAHA.118.011036
3. Gul F, Janzer SF. Peripheral vascular disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 May 1.
4. Hisam A, Ashraf F, Rana MN, Waqar Y, Karim S, Irfan F. Health-related quality of life in patients with single lower limb amputation. J Coll Physicians Surg Pak 2016; 26(10): 851-854.
5. Schober TL, Abrahamsen C. Patient perspectives on major lower limb amputation–A qualitative systematic review. Int J Orthop Trauma Nurs 2022; 46: 100958.
https://doi.org/10.1016/j.ijotn.2022.100958
6. Molina CS, Faulk J. Lower extremity amputation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021.
7. Moxey PW, Gogalniceanu P, Hinchliffe RJ, Loftus IM, Jones KJ, Thompson MM, et al. Lower extremity amputations: A review of global variability in incidence. Diabet Med 2011; 28(10): 1144-1153.https://doi.org/10.1111/j.1464-5491.2011.03279.x
8. Holman N, Young R, Jeffcoate W. Variation in the recorded incidence of amputation of the lower limb in England. Diabetologia 2012;55(7):1919-25.
https://doi.org/10.1007/s00125-012-2513-3
9. Soomro N, Bibi R, Ahmed SI, Kamran B, Minhas MA, Siddiqui KY. Epidemiology of amputation; low resource community: Sindh province, Pakistan. Professional Med J 2013; 20(2): 261-265.
10. Scott SW, Bowrey S, Clarke D, Choke E, Bown MJ, Thompson JP. Factors influencing short-and long-term mortality after lower limb amputation. Anaesthesia 2014; 69(3): 249-258.
https://doi.org/10.1111/anae.12538
11. Ahmad A, Ashfaq O, Akhtar N, Rana T, Gul M. Causes of lower limb amputation in patients registered at Pakistan Institute of Prosthetic and Orthotic Sciences Peshawar-Pakistan. Khyber Med Univ J 2019; 11(1): 41-44.
12. Chalya PL, Mabula JB, Dass RM, Ngayomela IH, Chandika AB, Mbelenge N, et al. Major limb amputations: A tertiary hospital experience in northwestern Tanzania. J Orthop Surg Res 2012; 7(1): 38.
https://doi.org/10.1186/1749-799X-7-18
13. Ambler GK, Thomas-Jones E, Edwards AG, Twine CP. Prognostic risk modelling for patients undergoing major lower limb amputation: an analysis of the UK National Vascular Registry. Eur J Vasc Endovasc Surg 2020; 59(4): 606-613.
https://doi.org/10.1016/j.ejvs.2019.12.006
14. Adams CT, Lakra A. Below knee amputation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018.
15. Russell Esposito E, Miller RH. Maintenance of muscle strength retains a normal metabolic cost in simulated walking after transtibial limb loss. PLoS One 2018; 13(1): e0191310.
https://doi.org/10.1371/journal.pone.0191310
16. Rathore FA, Ayaz SB, Mansoor SN, Qureshi AR, Fahim M. Demographics of lower limb amputations in the Pakistan military: a single center, three-year prospective survey. Cureus 2016; 8(4): e563.
https://doi.org/10.7759/cureus.563
17. De Klerk C, Du Plessis G, Fourie JJ, O'Neill A, Smit SJ, Joubert G. The eventual outcome of patients who had lower limb amputations due to peripheral vascular disease at Pelonomi Hospital, Bloemfontein. S Afr Fam Pract 2017; 59(1): 1-4.
https://doi.org/10.1080/20786190.2016.1254929
18. Pienaar E, Visagie S. Prosthetic use by persons with unilateral transfemoral amputation in a South African setting. Prosthet Orthot Int 2019; 43(3): 276-283.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Usman Jamil Mughal, Ali Hamza, Anum Arif, Nayab Munir Malik, Raoon Khan, Hammad Syed Rasool
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
