Risk of contralateral lower limb amputation and death after initial lower limb amputation - a population-based study

Area of Science:

• Vascular Surgery
• Epidemiology
• Public Health

Background:

• Lower limb amputation (LLA) is a severe complication of atherosclerosis, infection, and gangrene.
• The risk of contralateral limb amputation or death after an initial LLA is not well-established.
• This study compares risks after major versus minor ipsilateral LLA.

Purpose of the Study:

• To determine the incidence of contralateral major LLA after ipsilateral major or minor LLA.
• To compare the risk of death following ipsilateral major versus minor LLA.

Main Methods:

• Retrospective population-based cohort study in Ontario, Canada (2002-2012).
• Utilized linked administrative health databases.
• Employed Cox regression and cumulative incidence functions, excluding patients who died within 30 days of initial LLA.

Main Results:

• 5,816 adults had major LLA; 4,143 had minor LLA.
• Contralateral major LLA incidence was 4.8% after major LLA vs. 2.2% after minor LLA (aHR 2.41).
• Death incidence was 18.9% after major LLA vs. 11.4% after minor LLA (aHR 1.22).

Conclusions:

• High incidence of contralateral major LLA and elevated risk of death exist post-ipsilateral LLA.
• Urgent development of contralateral limb preservation strategies is recommended.
• Healthcare providers must prioritize preventative measures for at-risk patients.