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ISSN: 2329-910X

Clinical Research on Foot & Ankle
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  • Research Article   
  • Clin Res Foot Ankle, Vol 7(1): 284
  • DOI: 10.4172/2329-910X.1000284

Complications and Mortality after Major Amputation in Patients with Critical Limb Ischemia: A Single Center Experience

Persiani F1*, Filippi F1, D’Andrea A1, Raffaele D1, Ficarelli R1, Panzera C1, Rizzo L1, Hussein EA2 and Taurino M1
1Department of Vascular Surgery, Sant’Andrea Hospital, University of Rome–La Sapienza, Rome, Italy
2Department of Vascular Surgery, Ain Shams University, Cairo, Egypt
*Corresponding Author : Persiani F, Department of Vascular Surgery, Sant’Andrea Hospital, University of Rome–La Sapienza, Rome, Italy, Tel: +390633775988, Fax: +390633775324, Email: [email protected]

Received Date: Jan 02, 2019 / Accepted Date: Jan 30, 2019 / Published Date: Feb 06, 2019

Abstract

Objectives: Patients with critical limb ischemia (CLI) and undergoing major lower limb amputation carry a high risk of perioperative morbidity and mortality. This paper described complications and mortality rates in the short and long term after major amputation in patients with CLI and analyzed the preoperative comorbidities for predicting postoperative outcomes.

Methods: From January 2004 to March 2017, 140 consecutive major lower extremity amputations were performed in patients affected by CLI. Preoperative comorbidities associated with perioperative complications and mortality after lower extremity amputation were identified and analysed.

Results: Complication rate was 20%. There was a confirmed association between perioperative complications and congestive heart failure (OR 2.8, p=0.02), chronic obstructive pulmonary disease (COPD) (OR 0.3, p=0.02) and hypertension (OR 10.5, p=0.02). In-hospital mortality rate was 26.4% (n=37), 28.4% (n=31) of above-knee amputation (AKA) patients and 19.3% (n=6) of below-knee amputation (BKA) (p=0.3). Congestive heart failure was also significantly associated with in-hospital mortality (OR 2.3, p=0.04). Survival at 1, 2 and 5 years was 61.6%, 58.1% and 39.3% respectively. Advanced age was significant predictor of mortality (OR 3.8, p=0.001). Survival at 1, 2 and 5 years in AKA group was 53.3%, 50.2% and 33.3% respectively compared with BKA group in which survival at 1, 2 and 5 years was 88%, 83.1% and 58.2% respectively (p=0.004).

Conclusions: Nowadays, major amputation remains associated with high complication and mortality rates; some comorbidities seem to be associated with these outcomes.

Keywords: Amputation; Critical limb ischemia; Peripheral artery disease

Citation: Persiani F, Filippi F, D’Andrea A, Dito R, Ficarelli R, et al. (2019) Complications and Mortality after Major Amputation in Patients with Critical Limb Ischemia: A Single Center Experience. Clin Res Foot Ankle 7:284. Doi: 10.4172/2329-910X.1000284

Copyright: © 2019 Persiani F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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