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Point-Of-Care Ultrasound Screening for Proximal Lower Extremity Deep Venous Thrombosis
Published on: February 10, 2023
Death and venous thromboembolism after lower extremity amputation
M C Struijk-Mulder1, W van Wijhe, Y K Sze
1Department of Orthopaedic Surgery, Isala Clinics, Zwolle, The Netherlands.
Journal of Thrombosis and Haemostasis : JTH
|December 9, 2010
Summary
Lower extremity amputation carries a high mortality risk. This study found a significant incidence of venous thromboembolism (VTE) and death in patients undergoing amputation, highlighting VTE as a key contributor to poor outcomes.
Area of Science:
- Vascular Surgery
- Thrombosis Research
- Patient Outcomes
Background:
- Lower extremity amputation is a high-risk procedure for patients with end-stage vascular disease.
- The incidence of venous thromboembolism (VTE) in this patient population is not well-established.
Purpose of the Study:
- To determine the incidence of death and VTE following lower extremity amputation.
- To assess the contribution of VTE to morbidity and mortality in this patient group.
Main Methods:
- Prospective cohort study involving 53 amputations in 49 patients.
- Preoperative and postoperative ultrasonography and V/Q scans were used to detect VTE.
- Standard low-molecular-weight heparin thromboprophylaxis was administered.
Main Results:
- The overall mortality rate was 22.6% (12 of 53 amputations) within 8 weeks.
- The VTE rate was 13.2% (7 of 53 amputations), including fatal pulmonary embolisms.
- One asymptomatic deep vein thrombosis was also detected.
Conclusions:
- Lower extremity amputation is associated with substantial mortality, often due to sepsis, respiratory, or vascular causes.
- VTE significantly contributes to the morbidity and mortality after lower extremity amputation, even with thromboprophylaxis.
- This highlights the need for vigilant VTE monitoring and management in amputation patients.
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