Lower Extremity Amputations in At-Risk Patients

Kotha, Vikas S.; Ragothaman, Kevin; Walters, Elliot T.; Attinger, Christopher E.; Steinberg, John S.

doi:10.1016/j.cpm.2019.02.011

Cited by 4 publications

(1 citation statement)

References 29 publications

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“…Lower extremity amputation (LEA) consists of removing lower limbs by accident or surgery [ 1 ]. LEA is a severely disabling condition that imposes variable physical and psychological challenges as it entails lifestyle changes, self-concept alterations, impairments in physical functioning, and sensory effects [ 2 – 5 ]. LEA can occur as complications of trauma or underlying diseases, such as infections, tumours, cardiovascular or vascular diseases, especially diabetes mellitus (DM), and neglected congenital conditions [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Lower extremity amputations (LEAs) in a tertiary hospital in Togo: a retrospective analysis of clinical, biological, radiological, and therapeutic aspects

et al. 2023

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Background We analysed the clinical, biological, radiological profiles, and therapeutic patterns of the patients who underwent a surgical lower extremity amputation (LEA) in Togo from 2010 to 2020. Methods Retrospective analysis of clinical files of adult patients who underwent an LEA at a single centre (Sylvanus Olympio Teaching Hospital) from 1st January 2010 to 31st December 2020. Data were analysed by CDC Epi Info Version 7 and Microsoft Office Excel 2013 software. Results We included 245 cases. The mean age was 59.62 years (15.22 SD) (range: 15–90 years). The sex ratio was 1.99. The medical history of diabetes mellitus (DM) was found in 143/222 (64.41%) files. The amputation level found in 241/245 (98.37%) files was the leg in 133/241 (55.19%) patients, the knee in 14/241 (5.81%), the thigh in 83/241 (34.44%), and the foot in 11/241 (4.56%). The 143 patients with DM who underwent LEA had infectious and vascular diseases. Patients with previous LEAs were more likely to have the same limb affected than the contralateral one. The odds of trauma as an indication for LEA were twice as high in patients younger than 65 years compared to the older (OR = 2.095, 95% CI = 1.050–4.183). The mortality rate after LEA was 17/238 (7.14%). There was no significant difference between age, sex, presence or absence of DM, and early postoperative complications (P = 0.77; 0.96; 0.97). The mean duration of hospitalization marked in 241/245 (98.37%) files was 36.30 (1–278) days (36.20 SD). Patients with LEAs due to trauma had a significantly longer hospital admission than those with non-traumatic indications, F (3,237) = 5.505, P = 0.001. Conclusions Compared to previous decades, from 2010 to 2020, the average incidence of LEAs for all causes at Sylvanus Olympio Teaching Hospital (Lomé, Togo) decreased while the percentage of patients with DM who underwent LEAs increased. This setting imposes a multidisciplinary approach and information campaigns to prevent DM, cardiovascular diseases, and relative complications.

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