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Lower extremity amputation: the control series.

B A Keagy, J A Schwartz, M Kotb

    Journal of Vascular Surgery
    |October 1, 1986
    PubMed
    Summary
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    Major amputation surgery has significant risks, with below-knee amputations (BKAs) having a higher failure rate than above-knee amputations (AKAs). Clinical factors can identify high-risk patients who may not heal well after amputation.

    Area of Science:

    • Vascular Surgery
    • Clinical Outcomes Research
    • Patient Risk Stratification

    Background:

    • Amputation level determination is crucial for healing.
    • Despite advancements, predicting healing remains challenging.
    • Clinical factors may indicate poor healing potential.

    Purpose of the Study:

    • To analyze the association of clinical factors with amputation morbidity.
    • To identify predictors of poor healing after major limb amputation.
    • To evaluate failure rates of above-knee amputations (AKAs) versus below-knee amputations (BKAs).

    Main Methods:

    • Retrospective analysis of 1028 consecutive amputations in 786 patients over 13 years.
    • Data collected on clinical factors, operative mortality, and amputation healing.

    Related Experiment Videos

  • Comparison of failure rates between AKAs and BKAs.
  • Main Results:

    • Overall operative mortality was 7%, with cardiac complications being the leading cause of death.
    • 15.4% of amputations failed to heal, requiring revision; BKA failure rate (19%) was higher than AKA (9%).
    • Higher failure rates observed in white patients, non-diabetics, and those with heart disease.

    Conclusions:

    • Major amputation remains associated with significant morbidity and mortality.
    • Clinical factors can identify high-risk patients, particularly for BKA healing.
    • Prospective determination of amputation level may benefit high-risk individuals.