Major Lower Extremity Amputation in Veterans Affairs Medical Centers

Abstract

Our objective was to assess outcomes for 8696 patients who underwent 9236 above- (AKA) and/or below-knee (BKA) amputations during a 4-year period for disorders of the circulatory system. Veterans Affairs (VA) Patient Treatment File (PTF) data were acquired for all patients in Diagnosis Related Groups (DRGs) 113 and 114 hospitalized in VA medical centers (VAMCs) during fiscal years 1991-1994. Data were further analyzed by Patient Management Category (PMC) software, which measured illness severity, patient complexity, and relative intensity score (RIS), a measure of resource utilization. The results of this analysis showed that mortality and morbidity rates remain high after AKA and BKA. Differing amputation practice patterns found in this study warrant further investigation.

Factors Affecting Post-Operative Mortality Rate after Major Lower Extremity Amputations in a Tertiary Institution in Singapore

“…[1][2][3][4][5][6][7] Patient's pre-operative condition, including their ASA status, presence of septic shock and site of amputation undertaken are significant predictors of post-operative in hospital mortality rate and ICU admission rate. Patients with pre-operative septic shock, ASA 4 status and undergoing AKA should be regarding as high risk group, and appropriate level of intra-operative monitoring and post-operative disposition should be arranged.…”

“…[1][2][3][4][5][6][7] With the increasing incidence of diabetes mellitus in Asia, the incidence of MLEA surgeries is set to increase over the next few years [8][9][10] as diabetes is one of the major risk factors for critical limb ischaemia and lower limb amputation surgeries. 10 It is important to identify factors that affects outcome in this group of patients.…”

“…Studies have found the 30-day mortality rate for this group of patients to be ranging from 7-23%. [1][2][3][4][5][6][7] Patients undergoing these operations often have significant multiple comorbidities 4 and pre-operative hemodynamic disturbances, putting them at high risk both for surgery and for the further hemodynamic changes associated with anaesthesia. Most studies evaluating factors associated with peri-operative mortality rates in this group of patients are conducted in Caucasian populations, [3][4][5][6] and we find a lack of similar studies evaluating these factors in the Asian population.…”

Early outcome of vascular lower limb amputations at a National Referral Hospital in Kenya

“…The peri-operative mortality remains the same despite years of improvement in medical care, in excess of 10% in most studies (10)(11)(12)(13). In this study, the overall mortality was 24.4%.…”

Function and Pain in Community-Dwelling, Adult Mid-Southerners with Limb Loss

“…In-hospital mortality for older United States veterans undergoing amputation for vascular causes was 9.7% after below-the-knee amputation and 16.5% after above-the-knee amputation. 94 The five year survival rate after a lower limb amputation from diabetes in Brazil was reported to be 42.4%, 95 and 34.7% in the Northeastern United States. 96 Co-morbidities, including diabetes, cardiopulmonary disease, other diseases, and disability have been associated with poorer physical function in people with limb loss from the Netherlands.…”