Chronic kidney disease predicts long-term mortality after major lower extremity amputation

Abstract

Background:Despite low peri-operative mortality after major lower extremity amputation, long-term mortality remains substantial. Metabolic syndrome is increasing in incidence and prevalence at an alarming rate in the USA.Aim:This study was to determine whether metabolic syndrome predicts outcome after major lower extremity amputation.Patients and Methods:A retrospective review of charts between July 2005 and June 2010.Results:Fifty-four patients underwent a total of 60 major lower extremity amputations. Sixty percent underwent below-knee amputation and 40% underwent above-knee amputation. The 30-day mortality was 7% with no difference in level (below-knee amputation, 8%; above-knee amputation, 4%; P = 0.53). The mean follow-up time was 39.7 months. The 5-year survival was 54% in the whole group, and was independent of level of amputation (P = 0.24) or urgency of the procedure (P = 0.51). Survival was significantly decreased by the presence of underlying chronic kidney disease (P = 0.04) but not by other comorbidities (history of myocardial infarction, P = 0.79; metabolic syndrome, P = 0.64; diabetes mellitus, P = 0.56).Conclusion:Metabolic syndrome is not associated with increased risk of adverse outcomes after lower extremity amputation. However, patients with chronic kidney disease constitute a sub-group of patients at higher risk of postoperative long-term mortality and may be a group to target for intervention.

Predictors of in-hospital mortality following major lower extremity amputations in type 2 diabetic patients using artificial neural networks

“…Recently, Assi et al reported that patients with chronic kidney disease have higher risk (OR 2.27; 95% CI 1.02–5.06) of postoperative long-term mortality and concluded that how CKD contributes to worse survival is unclear [31]. …”