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Risk Factors for Early Lower Limb Re-Amputation in Vascular Diseases
Diego Castro Musial1, Maria Eduardha Ligocki Irigaray2, Lauanny Caroline Gerber2
1Hospital Regional Hans Dieter Schmidt, Joinville, Santa Catarina, Brazil.
Insights
Dialysis, smoking, and hypertension significantly increase the risk of lower limb re-amputation within six months. Early intervention for patients with these factors is crucial to prevent repeat amputations.
Area of Science:
- Medical research
- Surgical outcomes
- Public health
Background:
- Lower limb amputations carry known risks.
- Identifying predictors for repeat amputations is essential for patient care.
- This study focuses on re-amputation risk within six months of the initial procedure.
Purpose of the Study:
- To identify risk factors for re-amputation within six months of a lower limb amputation.
- To inform early interventions for high-risk patients.
Main Methods:
- Retrospective cohort study at a single center in Brazil (2013-2022).
- Included 652 adult patients undergoing lower limb amputation.
- Analyzed patient demographics, comorbidities, and amputation history using statistical tests.
Main Results:
- 35.2% of patients required re-amputation within six months.
- Dialysis (OR 8.36), smoking (OR 1.67), and hypertension (OR 1.55) were significant predictors of re-amputation.
- Statistical significance was determined using Chi-squared and student's t-tests.
Conclusions:
- Early intervention is vital for patients with identified risk factors.
- Targeted support for dialysis, smoking, and hypertension can reduce re-amputation rates.
- Proactive management can improve outcomes after lower limb amputation.
Background:
Numerous risk factors for lower limb amputations are known; however, this study aimed to identify risk factors for re-amputation in patients within 6 months from an initial lower limb amputation procedure.
Methods:
This single-center retrospective cohort study was performed at the Hospital Regional Hans Dieter Schmidt in Brazil. The study included patients who were aged at least 18 years and had undergone lower limb amputation between 2013 and 2022. Patients who died while hospitalized and patients who were lost to follow-up after hospital discharge were excluded from the study. Patient age, sex, number of amputations, revision time, comorbidities, and potential risk factors were extracted from the physical therapy service database and electronic medical records of the hospital. Chi-squared test and student's t-test were used to identify statistical significance.
Results:
A total of 652 patients were included, of which 35.2% (230) patients underwent re-amputation within 6 months of the first operation. We found that dialysis (P = 0.004; odds ratio [OR] 8.36, 95% confidence interval [CI] 3.09-20.5), smoking (P = 0.004; OR 1.67, 95% CI 1.18-2.35), and hypertension (P = 0.02; OR 1.55, 95% CI 1.09-2.19) were predictive factors for re-amputation within 6 months of lower limb amputation.
Conclusions:
Therefore, it is important to intervene early and provide additional support to patients undergoing lower limb amputation with these risk factors to reduce the potential for re-amputation in the future.
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