Morbid Implications of Above-Knee Amputations

Huston, C C

doi:10.1001/archsurg.1980.01380020033008

Cited by 41 publications

(6 citation statements)

References 14 publications

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“…[19][20][21][22][23] The most frequent site of chronic arterial occlusion in this investigation was the superficial femoral artery, in accordance with Roon et al 24 The percentage of patients who had undergone recent prior revascularization of the amputated limb was within the limits found in the literature. [25][26][27][28] We also observed that the concomitant bilateral amputations were in accordance with other reports that stated values of 10.68% to 15%. 23,29 Previous studies 30,31 reported that failed BKA occurs in approximately 15% of patients, similar to the incidence observed in the present study.…”

Section: Discussionsupporting

confidence: 91%

Incidence of ipsilateral postoperative deep venous thrombosis in the amputated lower extremity of patients with peripheral obstructive arterial disease

Matielo

Presti

Casella

et al. 2008

Journal of Vascular Surgery

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The incidence of DVT in the early postoperative period (or=70 years and for AKA. Patients with PAD who have recently undergone major amputations should be considered at high risk for DVT, even after hospital discharge. Given the high rate of postoperative DVT observed in this study, we now recommend prophylactic anticoagulation for these patients, but further study is needed to determine the optimal duration and efficacy of this treatment.

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Section: Discussionsupporting

confidence: 91%

Incidence of ipsilateral postoperative deep venous thrombosis in the amputated lower extremity of patients with peripheral obstructive arterial disease

Matielo

Presti

Casella

et al. 2008

Journal of Vascular Surgery

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“…In previous work, 30 prior vascular reconstructive procedures did not adversely affect prognosis after amputation; however, in our study such patients were more prone to have postoperative infection and revisions, although they were no more likely to die. The urge to attempt revascularization in essentially everybody needs to be tempered because failure may necessitate a higher amputation.…”

Section: Discussioncontrasting

confidence: 51%

“…Death after lower extremity amputation from sepsis or circulatory problems has been extensively discussed in the literature 1,21,22,30,40 . Reports indicate that one third are dead by the second year and two thirds within 5 years 21, 22, 42 .…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Lower Extremity Amputations

Weiss¹,

Gorton

Read

et al. 1990

J American Geriatrics Society

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In an effort to identify variables that could be used to predict outcomes of amputation, a cohort of 97 veteran amputees with a median age of 64 years who underwent 155 lower extremity procedures during 1984 was followed for 15 months. A high incidence of postoperative complication, revision, and mortality with poor quality of life confirm the serious prognosis of these individuals. Regression analyses indicated that peripheral vascular disease and prolonged preoperative hospitalization were associated with complications. Preoperative gangrene and peripheral vascular disease were associated with the need for revision. Complications, a low body mass index, and multiple diseases were related to death. Those with multiple diseases and extensive atherosclerosis were less likely to walk. Ability to perform activities of daily living was the most important predictor of quality of life. Patients at higher risk for these adverse outcomes need to be identified early in their hospital stay. The involvement of the patient or his or her surrogate in decisions regarding the course of treatment and the level of amputation is essential.

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“…Although improvements in outcomes have been reported at some centers, postoperative mortality has been substantial after major lower extremity amputation. [1][2][3][4][5][6][7][8][9][10][11] The purpose of this study was to define outcomes after above-knee (AKA) and below-knee amputation (BKA) for circulatory disease in all Veterans Affairs medical centers (VAMCs).…”

Section: Introductionmentioning

confidence: 99%

Major Lower Extremity Amputation in Veterans Affairs Medical Centers

Kazmers

Perkins²,

Jacobs

2000

Annals of Vascular Surgery

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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.

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Morbid Implications of Above-Knee Amputations

Cited by 41 publications

References 14 publications

Incidence of ipsilateral postoperative deep venous thrombosis in the amputated lower extremity of patients with peripheral obstructive arterial disease

Incidence of ipsilateral postoperative deep venous thrombosis in the amputated lower extremity of patients with peripheral obstructive arterial disease

Outcomes of Lower Extremity Amputations

Major Lower Extremity Amputation in Veterans Affairs Medical Centers

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