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1.
British Journal of Surgery ; 109, 2022.
Artigo em Inglês | Web of Science | ID: covidwho-2188312
2.
British Journal of Surgery ; 109(Supplement 5):v94, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2134960

RESUMO

Introduction: Major limb amputation (MLA) is The highest risk lower limb surgical procedure performed in The United Kingdom with reported in hospital mortality 9.1%. For patients with non-reconstructable arterial disease it of fers palliation of symptoms. The primary aim of The current work was to define if surgical palliation with major limb amputation is being of fered to patients who may have been best managed medically Methods: Retrospective review of major limb amputations (March 2019 to October 2021). Historical datasets have also been scrutinised (2008-2010). Specific variables of interest included The annual number of major limb amputations, mortality on The index admission and place of discharge. Result(s): A complete dataset was available for 282 patients during The COVID period. Patient demographics were as anticipated-206 (73%) male, mean age 63-years (range 23 to 90-years). Peripheral arterial disease (190) and diabetes mellitus (149) were common. The number of major limb amputations was comparable with The historical series. In-hospital mortality was 7% (n=20). The median duration of admission for patients who survived was 26-days and 38% of patients were limb-fitted (which was also comparable with historical data). Most patients (71%) were discharged to their own home. Conclusion(s): The outcomes described are better than The comparable local historical and national data both in terms of in-hospital mortality and place of discharge. These data imply that we make The correct decision about MLA more of ten than we don't.

3.
British Journal of Surgery ; 109(Supplement 5):v87, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2134908

RESUMO

Introduction: There have been significant changes in The delivery of Health care as a consequence of The COVID-19 pandemic. Standard operating procedures have been re-defined to minimise harm from The reduction in access to services, whilst at The same time protecting hospitals (and in particular critical care units) from admissions. We have explored major limb amputation (MLA) practice and compared this with a historical series. Method(s): Retrospective review of major limb amputations (March 2019 to October 2021). Historical datasets have also been scrutinised (2008-2010). Specific variables of interest included The annual number of major limb amputations, primary versus secondary amputation and ratio of transtibial (TTA) to transfemoral (TFA) amputations. Result(s): A complete dataset was available for 282 patients during The COVID period. Patient demographics were as anticipated-206 (73%) male, mean age 63-years (range 23 to 90-years). Peripheral arterial disease (190) and diabetes mellitus (149) were common. These demographics were comparable to The historical data. The annual number of MLA has not changed over The COVID period. The ratio of primary to secondary MLA was 1:1.3 in The historical series and 1:1 during The COVID period. The ratio of TTA to TFA was 3:1.8 in The historical series and 2:1 during The COVID period. Conclusion(s): The trends suggest that practice has not changed significantly during The COVID period. There has been a slight change in The ratio of transtibial to transfemoral amputation, which may reflect patients presenting with later stage disease.

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