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Descriptive Analysis of Perioperative Mortality Rates Following Major Amputations: A 15-Year Retrospective Study at a
Henrique Jose Pereira de Godoy1,2, Jose Maria Pereira de Godoy3,4, Thaisa Bonardi3
1Vascular Surgery, Faculty of Medicine of São José do Rio Preto (FAMERP), São José do Rio Preto, BRA.
None:
Background Lower limb amputations are frequently preceded by diabetic foot ulcerations. When these wounds are complicated by progressive bacterial infections, they can rapidly advance to moderate or severe stages, significantly elevating the necessity for limb amputation, reflecting in mortality risk. This study aimed to evaluate the perioperative mortality rate of major lower limb amputations between 2010 and 2024 at a teaching hospital. Methodology A retrospective study was conducted by reviewing the medical records of patients who underwent non-traumatic major amputations (transtibial and transfemoral) at the Hospital de Base (HB) in São José do Rio Preto between 2010 and 2024. The hospital is the second-largest teaching hospital in Brazil, serving as the clinical and teaching hospital for the Faculty of Medicine of São José do Rio Preto (FAMERP). It is a premier tertiary facility, heavily recognized for its intensive care medicine, cardiology, and trauma surgery. The study analyzed perioperative mortality rates stratified by age and sex. Statistical analysis was performed using descriptive methods to evaluate trends and demographic distributions over the 15-year period. Results A total of 1,744 patients were identified. The average age per year ranged from 61.56 to 68.8 years (mean = 64.82 years). Mortality occurred in 123 (19.46%) of 632 female patients and in 204 (18.21%) of 1,112 male patients (chi-square test: p-value = 0.56). Regarding deaths, there were 327 in total, varying by year from 11.45% to 25.5%, with 2021 being the most critical year, the main year of COVID-19 at the institution. The mean mortality rate was 19.02%. Before COVID-19 in 2010-2019, there were 234 deaths in 1,108 patients (20.1%), and during the COVID-19 period (2021 and 2022), there were 75 deaths in 408 patients (18.4%), with no statistically significant difference. Conclusions Mortality rates for non-traumatic patients undergoing major amputations from the emergency room admission remained high, making it necessary to address the issue as early as possible to prevent sepsis, the leading cause of mortality, and to improve prevention, especially for patients with diabetes, which was the most significant cause associated with amputation.
