TEMPLE, TX—While high mortality rates have been reported after major amputations of a lower limb secondary to diabetes and peripheral vascular disease, the mortality rates have varied across studies.
A systematic review of the five-year mortality after nontraumatic major amputations of the lower extremity was conducted, with results published in the Journal of Foot and Ankle Surgery.1
A study team led by podiatrists from the Central Texas VA Health Care System performed a Medline data search using OVID, CINHAL and Cochrane. After 365 abstracts were screened, 79 full text articles were assessed for eligibility; 31 studies met the inclusion and exclusion criteria.
Results indicate that, overall, the five-year mortality rate was very high among patients with any amputation, whether major or minor combined, ranging from 53% to 100%, and in patients with major amputations, ranging from 52% to 80%.
The review noted that mortality after below-the-knee amputation ranged from 40% to 82% and from 40% to 90% after above-the-knee amputation.
Risk factors for increased mortality included age, renal disease, proximal amputation and peripheral vascular disease, according to the report.
“Although our previous systematic review of the five-year mortality after ulceration had much lower rates of death, additional studies are warranted to determine whether amputation hastens death or is a marker for underlying disease severity,” study authors concluded.
- Thorud JC, Plemmons B, Buckley CJ, Shibuya N, Jupiter DC. Mortality After Nontraumatic Major Amputation Among Patients With Diabetes and Peripheral Vascular Disease: A Systematic Review. J Foot Ankle Surg. 2016 May-Jun;55(3):591-9. doi: 10.1053/j.jfas.2016.01.012. Epub 2016 Feb 19. Review. PubMed PMID: 26898398.