Predictive Factors for Mortality Following Major Lower Extremity Amputation.

Area of Science:

• Surgical Outcomes
• Clinical Risk Stratification
• Amputation Research

Background:

• Major amputation remains a high-risk procedure with significant mortality rates.
• Previous studies identified amputation level, renal function, and white cell count as mortality predictors.

Purpose of the Study:

• To identify factors associated with increased mortality risk following major amputation.
• To improve the prediction of short-term mortality after major amputation.

Main Methods:

• Retrospective chart review of patients undergoing major amputation at a single center.
• Statistical analyses including Chi-squared tests, t-tests, and Cox proportional hazard modeling.
• Examination of mortality at 6 and 12 months post-amputation.

Main Results:

• Six-month mortality risk factors: increased age, female sex, minority race, chronic kidney disease, and intraoperative pressor use.
• Twelve-month mortality risk factors were similar to six-month predictors.
• Significant associations found between specific patient demographics, comorbidities, and perioperative conditions with mortality.

Conclusions:

• High mortality rates persist for patients undergoing major amputation.
• Physiologically stressful amputation conditions are linked to increased 6-month mortality.
• Accurate prediction of 6-month mortality can aid clinical decision-making for surgeons and patients.