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Outcomes of lower extremity amputations.

G N Weiss1, T A Gorton, R C Read

  • 1Little Rock Plasma Alliance, Arkansas.

Journal of the American Geriatrics Society
|August 1, 1990
PubMed
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Predicting lower extremity amputation outcomes is crucial. Peripheral vascular disease and prolonged hospitalization increase complications, while preoperative gangrene and vascular disease predict revision needs, impacting veteran amputee prognosis.

Area of Science:

  • Vascular Surgery
  • Clinical Outcomes Research
  • Veteran Health

Background:

  • Lower extremity amputations carry significant risks, including complications, revisions, and mortality.
  • Quality of life is a critical outcome measure for amputee patients.
  • Identifying predictive factors for adverse outcomes is essential for improving patient care.

Purpose of the Study:

  • To identify variables that predict outcomes following lower extremity amputation.
  • To understand the factors associated with postoperative complications, revisions, mortality, and quality of life in veteran amputees.

Main Methods:

  • A cohort of 97 veteran amputees undergoing 155 lower extremity procedures was followed for 15 months.
  • Regression analyses were used to determine associations between preoperative and demographic variables and outcomes.

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  • Outcomes assessed included postoperative complications, need for revision, mortality, ambulation, and quality of life.

    • Main Results:

    • Peripheral vascular disease and prolonged preoperative hospitalization were linked to complications.
    • Preoperative gangrene and peripheral vascular disease predicted the need for revision.
    • Complications, low body mass index, and multiple comorbidities were associated with mortality.
    • Multiple diseases and extensive atherosclerosis reduced the likelihood of walking.
    • Activities of daily living performance was the strongest predictor of quality of life.

    Conclusions:

    • Veteran amputees face a serious prognosis with high rates of adverse outcomes.
    • Early identification of high-risk patients is necessary for timely intervention.
    • Patient involvement in treatment and amputation level decisions is vital for optimal care.