Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease
Background:. Mortality rates following major lower extremity amputations (LEAs) 30 days–365 days postoperative have decreased, but 5-year rates remain high at 40.4%–70%. These data may not reflect recent advances in peripheral arterial disease (PAD) care, and comorbidities of chronic PAD may lead to...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2023-01-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004727 |
| _version_ | 1797947130430619648 |
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| author | Summer A. Beeson, BS Daniel Neubauer, MD Richard Calvo, PhD Michael Sise, MD Matthew Martin, MD, FACS David S. Kauvar, MD, MPH Chris M. Reid, MD |
| author_facet | Summer A. Beeson, BS Daniel Neubauer, MD Richard Calvo, PhD Michael Sise, MD Matthew Martin, MD, FACS David S. Kauvar, MD, MPH Chris M. Reid, MD |
| author_sort | Summer A. Beeson, BS |
| collection | DOAJ |
| description | Background:. Mortality rates following major lower extremity amputations (LEAs) 30 days–365 days postoperative have decreased, but 5-year rates remain high at 40.4%–70%. These data may not reflect recent advances in peripheral arterial disease (PAD) care, and comorbidities of chronic PAD may lead to mortality more frequently than the amputation itself. Mortality rates between diabetic and nondiabetic patients were also analyzed.
Methods:. The California Office of Statewide Health Planning and Development hospital database was queried for patients admitted January 1, 2007–December 31, 2018. ICD-9-CM codes identified patients with vascular disease and an amputation procedure.
Results:. There were 26,669 patients. The 30-day, 90-day, 1-year, and 5-year major LEA mortality rates were 4.82%, 8.62%, 12.47%, and 18.11%, respectively. Weighted averages of 30-day, 90-day, 1-year, and 5-year major LEA mortality rates in the literature are 13%, 15.40%, 47.93%, and 60.60%, respectively. Mortality risk associated with vascular disease after amputation (hazard ratio = 22.07) was 11 times greater than risk associated with amputation-specific complications from impaired mobility (hazard ratio = 1.90; P < 0.01). Having diabetes was associated with lower mortality at 30 days, 90 days, and 1 year (P < 0.01) but not at 5 years (P = 0.22).
Conclusions:. This study suggests that people may be living longer after their major LEA than was previously thought. This study suggests that patients’ PAD may play a bigger role in contributing to their mortality than complications from loss of mobility postamputation. Although having diabetes was associated with lower postamputation mortality, the difference was no longer significant by 5 years. |
| first_indexed | 2024-04-10T21:21:53Z |
| format | Article |
| id | doaj.art-8c0995a5d65240a381d36dd85586c43d |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-10T21:21:53Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-8c0995a5d65240a381d36dd85586c43d2023-01-20T02:34:50ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-01-01111e472710.1097/GOX.0000000000004727202301000-00017Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular DiseaseSummer A. Beeson, BS0Daniel Neubauer, MD1Richard Calvo, PhD2Michael Sise, MD3Matthew Martin, MD, FACS4David S. Kauvar, MD, MPH5Chris M. Reid, MD6From the * Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Diego, San Diego, Calif.† Department of Surgery, Naval Medical Center San Diego, San Diego, Calif.‡ Mercy Hospital Trauma Research Department, Scripps Mercy Hospital, San Diego, Calif.§ Department of Surgery, Trauma Surgery Service, Scripps Mercy Hospital, San Diego, Calif.§ Department of Surgery, Trauma Surgery Service, Scripps Mercy Hospital, San Diego, Calif.¶ Department of Surgery, Vascular Surgery Service, Brooke Army Medical Center, Fort Sam Houston, Tex.From the * Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California San Diego, San Diego, Calif.Background:. Mortality rates following major lower extremity amputations (LEAs) 30 days–365 days postoperative have decreased, but 5-year rates remain high at 40.4%–70%. These data may not reflect recent advances in peripheral arterial disease (PAD) care, and comorbidities of chronic PAD may lead to mortality more frequently than the amputation itself. Mortality rates between diabetic and nondiabetic patients were also analyzed. Methods:. The California Office of Statewide Health Planning and Development hospital database was queried for patients admitted January 1, 2007–December 31, 2018. ICD-9-CM codes identified patients with vascular disease and an amputation procedure. Results:. There were 26,669 patients. The 30-day, 90-day, 1-year, and 5-year major LEA mortality rates were 4.82%, 8.62%, 12.47%, and 18.11%, respectively. Weighted averages of 30-day, 90-day, 1-year, and 5-year major LEA mortality rates in the literature are 13%, 15.40%, 47.93%, and 60.60%, respectively. Mortality risk associated with vascular disease after amputation (hazard ratio = 22.07) was 11 times greater than risk associated with amputation-specific complications from impaired mobility (hazard ratio = 1.90; P < 0.01). Having diabetes was associated with lower mortality at 30 days, 90 days, and 1 year (P < 0.01) but not at 5 years (P = 0.22). Conclusions:. This study suggests that people may be living longer after their major LEA than was previously thought. This study suggests that patients’ PAD may play a bigger role in contributing to their mortality than complications from loss of mobility postamputation. Although having diabetes was associated with lower postamputation mortality, the difference was no longer significant by 5 years.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004727 |
| spellingShingle | Summer A. Beeson, BS Daniel Neubauer, MD Richard Calvo, PhD Michael Sise, MD Matthew Martin, MD, FACS David S. Kauvar, MD, MPH Chris M. Reid, MD Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease Plastic and Reconstructive Surgery, Global Open |
| title | Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease |
| title_full | Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease |
| title_fullStr | Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease |
| title_full_unstemmed | Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease |
| title_short | Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease |
| title_sort | analysis of 5 year mortality following lower extremity amputation due to vascular disease |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004727 |
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