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Lower extremity amputation for peripheral vascular disease. A low-risk operation.
The American Surgeon
|November 1, 1984
Summary
Major lower extremity amputations for peripheral vascular insufficiency have a low operative mortality when aggressive medical management and timely surgery are employed. This approach yields mortality rates appropriate for the patient population.
Area of Science:
- Vascular Surgery
- Amputation Procedures
- Patient Outcomes
Background:
- Peripheral vascular insufficiency frequently necessitates major lower extremity amputation.
- Amputation procedures carry a reputation for high mortality and morbidity.
Purpose of the Study:
- To evaluate the operative mortality and outcomes of major lower extremity amputations.
- To assess the impact of aggressive medical management and timely surgical intervention on patient mortality.
Main Methods:
- A retrospective review of 253 consecutive major lower extremity amputations over a 3-year period.
- Analysis of operative mortality stratified by amputation level (below-knee vs. above-knee).
Main Results:
- Overall operative mortality was low.
- Below-knee amputations (n=113) had a 0.9% mortality rate.
- Above-knee amputations (n=140) had a 2.8% mortality rate.
Conclusions:
- The reputation for high mortality associated with lower extremity amputation is unwarranted.
- Adherence to a protocol of aggressive medical management and timely surgical intervention results in acceptable mortality rates.
- Outcomes are appropriate given the age and general health of the patient cohort.