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Published on: November 19, 2019
Daytime and scheduled surgery for major dysvascular lower extremity amputation
Martha Etlm Ignatiussen1, Poul Pedersen2, Gitte Holm2
1Department of Orthopaedic Surgery, Zealand University Hospital, Køge.
Scheduled daytime surgery for major lower extremity amputation (LEA) may reduce early failure rates. This study evaluated the impact of implementing scheduled surgery days on LEA outcomes.
Area of Science:
- Vascular Surgery
- Surgical Outcomes
- Patient Management
Background:
- Major lower extremity amputation (LEA) carries a high risk of complications and mortality.
- Improvements in care have not fully mitigated poor outcomes for LEA patients.
Purpose of the Study:
- To evaluate if scheduled surgery reduces the failure rate in patients undergoing major LEA.
- To compare outcomes between scheduled and non-scheduled surgery for LEA.
Main Methods:
- A total of 328 patients undergoing major LEA were analyzed from 2016-2019.
- Early failure was defined as re-amputation or revision within 30 days.
- A new regime of scheduled surgery days was implemented in 2018 for comparison.
Main Results:
- The intervention cohort had 59% of amputations on scheduled days versus 36% in the control group.
- Daytime surgery increased in the intervention group (72.4% vs 57.6%).
- The 30-day failure rate decreased to 11.0% in the intervention group compared to 16.4% in the control group.
Conclusions:
- Daytime surgery significantly reduced the risk of failure (6.8% vs 22.2%).
- Scheduled and daytime surgery for major LEA may potentially reduce early failure risk.
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