Natural History After Below-knee Amputation: Analysis of Survival and Prosthetic Fitting Over 2 Decades
| Autor: | Alina Velescu, Eduardo Mateos Torres, Lidia Marcos Garcia, Mónica Lacambra Peñart, Albert Clará Velasco, Carles Díaz Duran |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Reoperation medicine.medical_specialty medicine.medical_treatment Ischemia Artificial Limbs Walking 030230 surgery Infections Revascularization Amputation Surgical 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Prosthesis Fitting Humans Medicine Below knee amputation Survival analysis Aged Retrospective Studies Aged 80 and over Leg business.industry General Engineering Retrospective cohort study Middle Aged medicine.disease Survival Analysis Surgery Natural history Lower Extremity Amputation Etiology Female business |
| Zdroj: | Cirugía Española (English Edition). 98:403-408 |
| ISSN: | 2173-5077 |
| DOI: | 10.1016/j.cireng.2020.07.011 |
| Popis: | Introduction This study sought to evaluate the natural history of patients undergoing below-knee amputation (BKA) and compare their evolution over 2 decades, as well as survival predictors, prosthetic fitting, and contralateral amputation. Methods Retrospective study of 209 consecutive patients (mean age 72.9 years; 68% males) who underwent BKA in 2 periods: 1996–2005 and 2006–2015. The fitting of prostheses, risk of contralateral amputation and survival, as well as their predictive factors, were assessed by survival analysis. Results 133 BKA were performed from 1996 to 2005 and 106 from 2006 to 2015. The etiology that motivated the BKA was acute ischemia (4.3%), chronic ischemia (34.0%), infection (9.1%) or mixed (chronic+infection, 52.6%), with no differences found between periods. Survival: mortality within one month=9.2%, one year=31.9%, 2 years=43.8% and 5 years=63.9%, with no significant differences between the 2 periods. Prosthetic: the fitting rate was 44.5% throughout the follow-up, with no significant differences between the two periods. 41.1% patients managed to walk. Contralateral amputation: 20.1% of the patients later required a major contralateral amputation, with no significant differences between the two periods. Conclusions In the last decade, fewer BKA have been performed probably, due to higher previous interventional revascularization. Despite this, the results of fitting, contralateral amputation or survival was not modified. In any case, the number of patients who are able to achieve ambulation is modest, so it emphasizes the need for an optimal selection of patients with BKA with the goal of prosthetic fitting. |
| Databáze: | OpenAIRE |
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