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Updated: Feb 28, 2026

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Major Lower Limb Amputation: Outcomes are Improving.

David A Kelly1, Stephanie Pedersen1, Patrik Tosenovsky1

  • 1Department of Vascular Surgery, Royal Perth Hospital, Perth, Western Australia, Australia.

Annals of Vascular Surgery
|June 13, 2017
PubMed
Summary

Major lower limb amputations (MLLA) saw reduced complication rates and mortality between 2000-2002 and 2010-2012. Despite improvements in care, outcomes for MLLA patients remain serious, indicating a need for further advancements.

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Area of Science:

  • Vascular Surgery
  • Amputation Outcomes
  • Patient Care Improvement

Background:

  • Previous MLLA outcomes (2000-2002) reported a 54% complication rate and 10% 30-day mortality.
  • Significant advancements in endovascular techniques and care models have occurred since 2002.

Purpose of the Study:

  • To compare patient outcomes for major lower limb amputation (MLLA) between 2000-2002 and 2010-2012.
  • To evaluate the impact of evolving surgical techniques and care models on MLLA outcomes.

Main Methods:

  • Retrospective analysis of MLLA patient data from a vascular surgery database.
  • Data extraction included patient demographics, comorbidities, and postoperative outcomes.
  • Mortality clarification involved medical records, registries, and primary care provider contact.

Main Results:

  • Wound infection rates decreased from 26.4% to 12.4% (P=0.023).
  • ICU admission rates fell from 48.3% to 17.5% (P=0.001).
  • Overall mortality decreased from 60.92% to 46.39% (P=0.049), with 6-month and 1-year mortality also significantly reduced.

Conclusions:

  • Major lower limb amputation patients continue to present with substantial comorbid conditions.
  • Improvements in revascularization, surgical supervision, and multidisciplinary care have led to reduced complications and mortality.
  • Despite progress, MLLA outcomes necessitate ongoing efforts for further improvement.