Limb Amputations at A Rural Tertiary Hospital: Evaluating Patient Characteristics, Risk Factors for Mortality, and Functional Outcomes

Abstract

Introduction

Amputation is the surgical removal of a body part. Trauma, infections, and non-communicable diseases are among indications of amputations, but changing trends have been highlighted in various regions. We aimed to describe the experience of limb amputations at our hospital to highlight patient characteristics, risk factors for mortality, and functional outcomes.

Methods

The study was a descriptive, retrospective case series of all patients who underwent limb amputation from January 1st 2018 to December 31st 2019. Patient data, including demographics, details of presentation, laboratory values, comorbidities, operations, and outcomes, were extracted from the electronic medical record. The primary outcomes were postoperative function and mortality. Comparison by risk factors for mortality was performed.

Results

154 patients underwent amputation. 121 (78.5%) were lower limb amputations. The average age was 52.2 years. Average duration of illness was 120 days. 93 (60.4%) patients were men. 82 (53.9%) had at least one comorbidity. Trauma was an indication for 57 (37%) patients and 74 (48%) had arterial disease. Diabetes was the most common comorbidity (N=62; 40%). The in-hospital mortality rate was 10.4% (N=16). Patients with a presenting diagnosis of diabetes had increased mortality when compared to those without diabetes (19.2% vs. 5.9%; p=0.01). For the functional outcome, 59 (47.2%) were ambulant on crutches and 27 (21.6%) were using a wheelchair.

Conclusions

Trauma and vascular disease frequently contributes to the need for amputation in our region. Diabetes was present in one third of the patients, and was a significant risk factor for mortality. Recognition of the impact of medical comorbidities is warranted given these findings.