Outcomes after minor lower limb amputation for peripheral arterial disease and diabetes: population-based cohort study #ActAgainstAmputation @ALPSlimb @BJSurgery

Strong work from our colleagues in Hull, Stoke, and London. These data line up well with previous works from our team and others.

Published in: British Journal of Surgery

Date of Publication: 22 May 2023

This study aimed to evaluate the rates of re-amputation and death following an initial minor amputation among patients with diabetes and/or peripheral arterial disease (PAD), and to identify associated risk factors. The study used data from Hospital Episode Statistics for all patients aged 40 years and above with diabetes and/or PAD who underwent minor amputation between January 2014 and December 2018.

Key Findings:

Out of the 22,118 patients studied, the majority (76%) were male, and a substantial proportion (83.5%) had diabetes.

A year after minor amputation, the estimated rate of ipsilateral major amputation was 10.7%.

Factors linked with a higher risk of ipsilateral major amputation included male sex, severe frailty, diagnosis of gangrene, emergency admission, foot amputation (compared to toe amputation), and previous or concurrent revascularization.

The estimated mortality rate was 17.2% at 1 year and 49.4% at 5 years post-minor amputation.

Risk factors associated with significantly higher mortality included older age, severe frailty, comorbidity, gangrene, and emergency admission.

The study concluded that minor amputations were associated with a high risk of major amputation and death. Within the first year following minor amputation, about one in ten patients had an ipsilateral major amputation, and half had died by five years.

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