Below-Knee Amputation Failure and Poor Functional Outcomes Are Higher Than Predicted in Contemporary Practice
| Autor: | Bjoern D. Suckow, Ryland S. Stucke, Karen L. Walker, Jesse A. Columbo, David H. Stone, Brian W. Nolan, Eva M. Rzucidlo, Richard J. Powell |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Time Factors medicine.medical_treatment Kaplan-Meier Estimate 030204 cardiovascular system & hematology 030230 surgery Amputation Surgical Disease-Free Survival Tertiary Care Centers 03 medical and health sciences Disability Evaluation Peripheral Arterial Disease 0302 clinical medicine Postoperative Complications Risk Factors medicine Humans New Hampshire Below knee amputation Treatment Failure Aged Retrospective Studies Aged 80 and over Leg business.industry General Medicine Critical limb ischemia Recovery of Function Middle Aged Amputation revision Amputation Physical therapy Surgery Female medicine.symptom Cardiology and Cardiovascular Medicine business Blood Gas Monitoring Transcutaneous |
| Zdroj: | Vascular and endovascular surgery. 50(8) |
| ISSN: | 1938-9116 |
| Popis: | Objective: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. Methods: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded. Study end points included freedom from conversion to above-knee amputation (AKA), freedom from conversion to AKA or death, BKA healing, and ambulation. Statistical modeling was performed to determine associations with BKA failure. Results: Over the study interval, 130 limbs underwent BKA in 120 patients. Transcutaneous oximetry studies were obtained in 65% (n = 85). Thirty-eight percent (n = 46) of all BKA patients went on to heal and ambulate. Twenty-five percent (n = 33) required reintervention, 24 with conversion to AKA, and 9 with BKA revision. One-year freedom from conversion to AKA was 76% and was decreased among those with lower TcPO2 levels (60% TcPO2 Conclusion: Despite a perceived functional bias toward knee salvage at the time of major amputation, most patients failed to postoperatively ambulate. Those with decreased TcPO2 levels ( |
| Databáze: | OpenAIRE |
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