Functional Outcome After Lower Limb Amputation: Is Hyperhomocysteinemia a Predictive Factor?: An Observational Study

Area of Science:

• Vascular Surgery
• Metabolic Disorders
• Rehabilitation Medicine

Background:

• Lower limb amputation (LLA) is a severe complication of peripheral arterial disease (PAD).
• Hyperhomocysteinemia (H-HCY) is a potential risk factor for PAD, but its role in LLA patients is understudied.
• Understanding H-HCY levels and their impact is crucial for improving outcomes in LLA.

Purpose of the Study:

• To investigate HCY levels in patients with LLA.
• To determine the correlation between HCY levels and functional outcomes post-LLA.
• To compare HCY levels between dysvascular amputees and controls.

Main Methods:

• A case-control study was conducted over 1.5 years.
• HCY levels were analyzed in 91 dysvascular amputees and 44 controls (amputees for other reasons).
• Functional outcomes were assessed using the Barthel Index.

Main Results:

• Dysvascular amputees showed significantly higher mean HCY levels (15.2 ± 7.5) compared to controls (11.0 ± 5.0, P < 0.0001).
• A risk ratio of 4.78 for elevated HCY was observed in dysvascular amputees.
• A significant negative correlation (R = -0.37, P = 0.001) was found between HCY levels and rehabilitation effectiveness in dysvascular amputees.

Conclusions:

• Patients with LLA due to PAD have significantly higher HCY levels than amputees without PAD.
• H-HCY appears to negatively influence functional outcomes following rehabilitation in LLA patients with PAD.