Can Early Post-Operative Scoring of Non-Traumatic Amputees Decrease Rates of Revision Surgery?
Medicina (Kaunas)
; 60(4)2024 Mar 30.
Article
in En
| MEDLINE
| ID: mdl-38674211
ABSTRACT
Background and Objectives:
Medical registries evolved from a basic epidemiological data set to further applications allowing deriving decision making. Revision rates after non-traumatic amputation are high and dramatically impact the following rehabilitation of the amputee. Risk scores for revision surgery after non-traumatic lower limb amputation are still missing. The main objective was to create an amputation registry allowing us to determine risk factors for revision surgery after non-traumatic lower-limb amputation and to develop a score for an early detection and decision-making tool for the therapeutic course of patients at risk for non-traumatic lower limb amputation and/or revision surgery. Materials andMethods:
Retrospective data analysis was of patients with major amputations lower limbs in a four-year interval at a University Hospital of maximum care. Medical records of 164 patients analysed demographics, comorbidities, and amputation-related factors. Descriptive statistics analysed demographics, prevalence of amputation level and comorbidities of non-traumatic lower limb amputees with and without revision surgery. Correlation analysis identified parameters determining revision surgery.Results:
In 4 years, 199 major amputations were performed; 88% were amputated for non-traumatic reasons. A total of 27% of the non-traumatic cohort needed revision surgery. Peripheral vascular disease (PVD) (72%), atherosclerosis (69%), diabetes (42%), arterial hypertension (38%), overweight (BMI > 25), initial gangrene (47%), sepsis (19%), age > 68.2 years and nicotine abuse (17%) were set as relevant within this study and given a non-traumatic amputation score. Correlation analysis revealed delayed wound healing (confidence interval 64.1% (47.18%; 78.8%)), a hospital length of stay before amputation of longer than 32 days (confidence interval 32.3 (23.2; 41.3)), and a BKA amputation level (confidence interval 74.4% (58%; 87%)) as risk factors for revision surgery after non-traumatic amputation. A combined score including all parameters was drafted to identify non-traumatic amputees at risk for revision surgery.Conclusions:
Our results describe novel scoring systems for risk assessment for non-traumatic amputations and for revision surgery at non-traumatic amputations. It may be used after further prospective evaluation as an early-warning system for amputated limbs at risk of revision.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Reoperation
/
Amputation, Surgical
/
Amputees
Limits:
Adult
/
Aged
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Aged80
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Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Medicina (Kaunas)
Journal subject:
MEDICINA
Year:
2024
Document type:
Article
Affiliation country: