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Published on: September 22, 2020
The effect of amputation level on patient mental and psychological health, prospective observational cohort study
A Abdel Rahim1, A Tam1, M Holmes1
1Department of Vascular Surgery, University Hospitals Plymouth NHS Trust, United Kingdom.
Background:
Non-traumatic lower limb amputation is a commonly performed surgical procedure and is associated with a high prevalence of psychological morbidity including anxiety and depression. Many risk factors have been identified, including the indication for amputation, perioperative pain and sociodemographic factors.
Objective:
The aim of this study was to identify whether level of amputation has an impact on this psychological morbidity.
Methods:
A prospective observational study was conducted in a tertiary vascular unit including all adult non-traumatic amputations performed during a 6 month period. The Hospital Anxiety and Depression Scale (HADS) was used to score anxiety and depression pre and postoperatively.
Results:
49 patients met the inclusion criteria (22 trans-femoral amputations (AKA) and 27 trans-tibial amputations (BKA)). HADS scores for anxiety and depression were high in both groups both pre and postoperatively. A higher level of anxiety was noted in the BKA group, significantly decreasing postoperatively (p < 0.05). No other statistically significant differences were found between the two groups.
Conclusion:
In non-traumatic amputations, there appears to be a higher rate of pre-operative anxiety in patients undergoing trans-tibial amputation compared with trans-femoral amputees. However, the level of amputation does not appear to have a significant effect on psychological status of patients with high rates of depression and anxiety demonstrated in both groups.
