The Effect of Revascularization versus Amputations on Patient Mental Health in the Early Postoperative Period: A...

Management of peripheral vascular disease often requires multiple interventions and hospital admissions, affecting patients' mental and psychological health. This study compares the effect of open and endovascular interventions for revascularization with major lower limb amputations (MLLA) on patients' depression and anxiety scores.

A prospective study of patients who underwent open or endovascular revascularization interventions or MLLAs at a tertiary referral center between January and June 2021 was conducted. Data were collected on demographics, length of stay, comorbidities including previous psychological issues, previous revascularization or amputation, presence or absence of perioperative pain, and rehospitalization. Patients were asked to fill in the hospital anxiety and depression scale 1-week pre-intervention and 6-8 weeks postinterventions, and outcomes were statistically analyzed.

A total of 122 patients (73 revascularizations vs. 49 amputations) were included in the study; 57.4% had diabetes, 43.4% had hypertension, 31.1% had ischemic heart disease, and 42.6% had previous revascularization interventions. The median and interquartile range of inpatient admission days was 10 (5-21) and 14 (9-21) for revascularization and amputation groups, respectively (P = 0.04). Median preoperative depression scores were 6 (range 2-8) and 8 (range 5-11), and postoperative scores were 4 (range 2-7) and 9 (range 8-13) for the revascularization and amputation groups, respectively. Median preoperative anxiety scores were 6 (range 2-10) and 11 (6-13), and postoperative scores were 5 (range 2-9) and 9 (5-11) for the revascularization and amputation groups, respectively. All preoperative and postoperative scores were significantly different between the two intervention groups (P < 0.05, 95% confidence interval).

Amputation negatively affects the patient's mental and psychological health as compared to revascularization.