Lower limb amputee survival

Abstract

A total of 1710 primary amputees have been studied over a 25 year period and their survival time has been calculated. These were all consecutive primary lower limb amputees admitted to the Dundee Limb Fitting Centre during the period 1965–1989. Overall, the median survival was 4 yr 9 mth for the below-knee amputee (1019 patients) and 4 yr 3 mth for the above-knee amputee (586 patients). The vascular related amputees had an overall median survival of 4 yr. In the two decades 1970–1979 and 1980–1989 there were significant differences between the survival time of the below-knee and above-knee amputee. The survival of the amputee has increased during the two decades from 3 yr 6 mth to 6 yr 6 mth (p>0.001). For the first decade male above-knee and male below-knee amputee median survival was 3 yr 1 mth and 3 yr 11 mth respectively and for the second the survival was 5 yr 9 mth and 6 yr 11 mth for these levels of amputation. For 1970–1979 no significant differences were found between male and female peripheral vascular disease (PVD) and diabetes mellitus related amputee survival. For 1980–1989 significant differences were found between PVD related male above-knee amputees (3 yr 10 mth) and male below-knee amputees (6 yr 7 mth) (p>0.01). Similar results were found for the female patients. Operative mortality was found to be 5% over the period 1975–1989 which compared favourably with previous studies.

Relative mortality in lower limb amputees with diabetes mellitus

“…It has only been possible to find two studies (Larsson, 1994;Stewart et al, 1992) analysing the relative mortality exclusively for diabetic amputees, with a longer observation period, but no studies have had an observation period of 12 years as in the present study.…”

“…A large number of authors (Lippman, 1979;Larsson, 1994;Hansson, 1964;Whitehouse et al, 1968;Kolind-Sorensen, 1974;Ebskov and Josephson, 1980;Finch et al, 1980;Mandrup-Poulsen and Jensen, 1982;Burgess and Romano, 1971;Persson and Suden, 1971;Ebskov, 1991b;Pohjolainen and Alaranta, 1988;Stewart et al, 1992) have analysed the mortality (in-hospital, postoperative, SMR) or the long term survival for vascular insufficiency amputations (with or without diabetes). Fewer have examined exclusively diabetic cases (Larsson, 1994;Hansson, 1964, Pohjolainen andAlaranta, 1988;Stewart et al, 1992;Silbert, 1952;Nelson et al, 1988). As mentioned by some authors (Mandrup-Poulson and Jensen, 1982;Stewart et al, 1992) there are major differences in defining the materials as regards important determinants like post-operative period, hospitalisation time, age, amputation level (especially inclusion of toe-amputations) and etiology of amputation cause.…”

“…Fewer have examined exclusively diabetic cases (Larsson, 1994;Hansson, 1964, Pohjolainen andAlaranta, 1988;Stewart et al, 1992;Silbert, 1952;Nelson et al, 1988). As mentioned by some authors (Mandrup-Poulson and Jensen, 1982;Stewart et al, 1992) there are major differences in defining the materials as regards important determinants like post-operative period, hospitalisation time, age, amputation level (especially inclusion of toe-amputations) and etiology of amputation cause. Further the materials are of variable size and the degree of specialisation for the clinics involved is different.…”

Determination of the Level of Amputation in Patients With Peripheral Vascular Disease

“…U sprovedenoj retrospektivnoj studiji vidimo da su odnos muško-žensko, proporcija unilateralnih i bilateralnih amputiraca kao i dijagnoze koje su vodile ka amputaciji u skladu sa onim koje su raportirane u drugim studijama [12][13] . Srednje godine starosti pri amputaciji (65 godina) su također u skladu sa raportiranim u drugim studijama [12][13][14] . U nekim studijama koje su uključivale i žrtve traume, srednje godine pri amputaciji su znatno niže, što je razumljivo.…”

Early Planning of Care and Rehabilitation after Amputation for Vascular Disease by Means of Katz Index of Activities of Daily Living

“…A mortality rate within one month of 16-21% has been reported during the last decade (6-8). The median survival of trans-tibia1 dysvascular amputees was 4 years and 2 months in a Scottish study (9) and 1 year and 6 months for all dysvascular amputees in a Finnish study, with diabetes patients living a few months longer (6). The survival for all amputees at 10 years has been found to be 15% (6).…”