Major Lower Limb Amputation for Chronic Limb-Threatening Ischemia Is Associated with Poor Long-Term Survival: 4-Year Follow-Up of a Single-Center Experience.
| Autor: | Gooneratne T; Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka., Cassim R; Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka., Wijeyaratne M; Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. |
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| Jazyk: | angličtina |
| Zdroj: | Annals of vascular diseases [Ann Vasc Dis] 2024 Sep 25; Vol. 17 (3), pp. 234-240. Date of Electronic Publication: 2024 Jul 06. |
| DOI: | 10.3400/avd.oa.23-00078 |
| Abstrakt: | Objective: Despite advances in medicine, 30% of patients with chronic limb-threatening ischemia (CLTI) require major lower limb amputation (MLLA). The long-term outcome of this cohort is poorly described. Methods: In all, 154 patients undergoing MLLA for CLTI during 2018-2020 were analyzed for short-term and long-term outcomes and prosthesis use. Results: In total, 106 below-knee amputations and 48 above-knee amputations were followed up for a mean duration of 50 months (37-78). The mean age of the cohort was 63 years. The majority were male (60%) with multiple comorbidities, including diabetes (83.8%), hypertension (49.4%), ischemic heart disease (20%), and smoking (32.5%). An equal proportion underwent MLLA as primary (45%) or secondary (55%). 30-day mortality was 6%. The mean length of in-hospital stay was 18 days (3-56). Overall survival rates at 1st, 2nd, and 4th year were 73%, 64%, and 35%, respectively. On a multivariate regression analysis, a higher level of amputation had a significant impact on mortality (p = 0.015). 54% of amputees had a prosthetic limb. However, the primary use of prosthesis was for cosmesis, with only 12% mobile independently. Conclusions: MLLA for CLTI is associated with poor early and long-term survival. Prosthesis use and mobility are extremely poor in the Sri Lankan context. (@ 2024 The Editorial Committee of Annals of Vascular Diseases.) |
| Databáze: | MEDLINE |
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