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SHORT AND LONG TERM MORTALITY RATES AFTER MAJOR LOWER LIMB AMPUTATION IN PATIENTS OLDER THAN 80 YEARS
| Resumo: | Introduction: Mortality rates after lower limb amputation are notoriously high and age is associated with increased mortality. The aim of this retrospective study was to determine mortality rates after a first major lower limb amputation in a cohort of patients older 80 years old. Methods: We performed an analysis of factors affecting early and late outcome after major lower limb amputation for peripheral vascular disease or diabetic complications at a tertiary referral vascular center between 2008 and 2015 in patients older than 80 years old. Results: 557 patients underwent a major amputation (54% female), of median age 86.3 ± 4.4 years and 20% had bilateral amputations during the study period. Median follow-up was 4.8 [0.8; 16.4] months. 30-day and 2-year mortality rates were 27% and 77%. Age adjusted 1-year mortality rate after trans-femoral amputation (TFA) was 68%, almost double that of trans-tibial amputation (TTA) (36%, p= .04). The rate of re-operation was substantially greater after TTA (36% vs 17%, p< .01). Survival and Cox regression analysis demonstrated that long-term mortality was associated with hospital re-admission (HR: 2.00, p <.05) cerebrovascular and chronic kidney disease (HR: 1.22 and 1.24 respectively, p <.05), acute ischemic amputation (HR 1.21 p <.05). Previous revascularized amputees and TTA survived longer (HR 0.65 and 0.51 respectively, p <.01). Conclusions: This study adds prognostic information for a well-defined population of people with a first amputation at or proximal to a transtibial level, due to a vascular or a infection related cause. Mortality rates after lower limb amputation are notoriously high, with only 23% of these cohort patients living longer than two years. |
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| Assunto: | mortality diabetic foot pé diabético Amputação peripheral arterial disease doença arterial periférica Amputation mortalidade |
| País: | Portugal |
| Tipo de documento: | journal article |
| Tipo de acesso: | Restrito |
| Instituição associada: | Angiologia e Cirurgia Vascular |
| Idioma: | inglês |
| Origem: | Angiologia e Cirurgia Vascular |
| _version_ | 1850560651918835712 |
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| conditionsOfAccess_str | Copyright (c) 2017 Angiologia e Cirurgia Vascular |
| contentURL_str_mv | http://acvjournal.com/index.php/acv/article/view/113 http://acvjournal.com/index.php/acv/article/view/113/22 |
| country_str | PT |
| description | Introduction: Mortality rates after lower limb amputation are notoriously high and age is associated with increased mortality. The aim of this retrospective study was to determine mortality rates after a first major lower limb amputation in a cohort of patients older 80 years old. Methods: We performed an analysis of factors affecting early and late outcome after major lower limb amputation for peripheral vascular disease or diabetic complications at a tertiary referral vascular center between 2008 and 2015 in patients older than 80 years old. Results: 557 patients underwent a major amputation (54% female), of median age 86.3 ± 4.4 years and 20% had bilateral amputations during the study period. Median follow-up was 4.8 [0.8; 16.4] months. 30-day and 2-year mortality rates were 27% and 77%. Age adjusted 1-year mortality rate after trans-femoral amputation (TFA) was 68%, almost double that of trans-tibial amputation (TTA) (36%, p= .04). The rate of re-operation was substantially greater after TTA (36% vs 17%, p< .01). Survival and Cox regression analysis demonstrated that long-term mortality was associated with hospital re-admission (HR: 2.00, p <.05) cerebrovascular and chronic kidney disease (HR: 1.22 and 1.24 respectively, p <.05), acute ischemic amputation (HR 1.21 p <.05). Previous revascularized amputees and TTA survived longer (HR 0.65 and 0.51 respectively, p <.01). Conclusions: This study adds prognostic information for a well-defined population of people with a first amputation at or proximal to a transtibial level, due to a vascular or a infection related cause. Mortality rates after lower limb amputation are notoriously high, with only 23% of these cohort patients living longer than two years. |
| documentTypeURL_str | http://purl.org/coar/resource_type/c_6501 |
| documentType_str | journal article |
| id | bd3ed6d4-9c72-4ccc-a352-91a93cdabc5c |
| identifierDoi_str | https://doi.org/10.48750/acv.113 |
| language | eng |
| relatedInstitutions_str_mv | Angiologia e Cirurgia Vascular |
| resourceName_str | Angiologia e Cirurgia Vascular |
| spellingShingle | SHORT AND LONG TERM MORTALITY RATES AFTER MAJOR LOWER LIMB AMPUTATION IN PATIENTS OLDER THAN 80 YEARS mortality diabetic foot pé diabético Amputação peripheral arterial disease doença arterial periférica Amputation mortalidade |
| title | SHORT AND LONG TERM MORTALITY RATES AFTER MAJOR LOWER LIMB AMPUTATION IN PATIENTS OLDER THAN 80 YEARS |
| topic | mortality diabetic foot pé diabético Amputação peripheral arterial disease doença arterial periférica Amputation mortalidade |