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Changing patterns in the predisposition for amputation of the lower extremities.
C S Lee1, J Sariego, T Matsumoto
1Department of Surgery, Hahnemann University Medical School, Philadelphia, Pennsylvania 19102.
The American Surgeon
|August 1, 1992
Summary
This study on lower extremity amputations found hypertension, not diabetes alone, was more often the primary condition. Better hypertension control may reduce future amputations.
Area of Science:
- Vascular Surgery
- Diabetology
- Epidemiology
Background:
- Peripheral vascular disease (PVD) frequently leads to lower extremity amputations.
- Identifying predisposing factors is crucial for preventative strategies.
Purpose of the Study:
- To evaluate the role of diabetes and other factors in lower extremity amputations.
- To determine the dominant underlying condition in patients with PVD and amputation.
Main Methods:
- Retrospective review of 110 patients with PVD undergoing amputation (1987-1990).
- Exclusion of trauma and cancer-related amputations.
- Categorization by amputation site: Above Knee, Below Knee, Foot, Transmetatarsal.
Main Results:
- Mean age 60 years; 58% male, 51% white.
- 26% were cigarette smokers; 32% had prior vascular surgery.
- Hypertension alone (32 patients) was more dominant than diabetes alone (10 patients) as an underlying condition.
Conclusions:
- Hypertension, more than diabetes alone, appears to be a critical factor in PVD-related amputations.
- Enhanced hypertension management could potentially decrease the incidence of lower extremity amputations.