Major lower extremity amputations in a developing country: 10-Year experience at a tertiary medical center
| Autor: | Caroline Hmedeh, Fady Haddad, Mohamad A. Chahrour, Mouafak Homsi, Mohammad Rachad Wehbe, Jamal J. Hoballah |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Developing country Comorbidity 030204 cardiovascular system & hematology Risk Assessment Amputation Surgical Tertiary Care Centers Peripheral Arterial Disease 03 medical and health sciences 0302 clinical medicine Risk Factors Prosthesis Fitting medicine Humans Radiology Nuclear Medicine and imaging Center (algebra and category theory) 030212 general & internal medicine Lebanon Mobility Limitation Developing Countries Aged Retrospective Studies Aged 80 and over business.industry General surgery General Medicine Middle Aged Treatment Outcome Lower Extremity Amputation Female Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Vascular. :170853812096508 |
| ISSN: | 1708-539X 1708-5381 |
| Popis: | Background Lower extremity amputation (LEA) is a major surgical procedure with a high risk of significant morbidity and mortality. The objective of this study was to describe mortality and functionality outcomes following this procedure in a developing country. Methods This is a retrospective study of all patients undergoing LEA for non-traumatic etiology between 2007 and 2017. Medical records were used to retrieve demographics, comorbidities, and perioperative complications of identified patients. Patients were contacted to follow-up on their medical, postoperative care, and ambulatory status. Mortality and postoperative functionality rates were analyzed. Results The study included 78 patients. Median follow-up duration was 24 months. Hypertension (81%) and diabetes (79%) were the most common comorbidities. Mortality rates at 30 days, 1, and 5 years were 10.3, 29.2, and 65.5%, respectively. Mortality was significantly associated with age > 70 at amputation ( p = 0.042), hypertension ( p = 0.003), chronic kidney disease ( p = 0.031), and perioperative sepsis ( p = 0.01). Only 1.6% of patients were discharged into a specialized care center, and only 27% of patients were ambulatory postoperatively, although 90.5% were fitted with a prosthesis. Conclusions Survival following major amputation in a developing country is currently comparable to more developed regions of the world. Major discrepancy seems to exist in ambulatory status following the procedure. Discharge placement policies should be properly set, and rehabilitation centers funding should be increased. Awareness may also be warranted to educate patients and families about the value and positive impact of rehabilitation centers. |
| Databáze: | OpenAIRE |
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