Analyzing Morbidity and Mortality of Transmetatarsal Amputations #ActAgainstAmputation #ALPSLimb

Prof. Andrew J. Meyr, alongside his team from Temple University, recently published a study in the Journal of Foot and Ankle Surgery focusing on the morbidity and mortality associated with transmetatarsal amputations. The objective of this research was to compare the morbidity and mortality of transmetatarsal amputations to other frequently performed surgical procedures utilizing a large US database.

The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database served as the data source for this investigation. The team initially extracted data related to the Current Procedural Terminology (CPT) code 28805 (amputation, foot; transmetatarsal) and the variable labels “estimated probability of morbidity” and “estimated probability of mortality”. They subsequently performed a CPT code search for those procedures occurring at a frequency greater than 10,000 in the database, extracting data for estimated probability of morbidity and estimated probability of mortality for these procedures.

The results revealed that CPT code 28805 was associated with the highest estimated probability of morbidity of the cohort (0.1360±0.0669), demonstrating statistical significance higher than all other CPT codes (p<0.001). Moreover, CPT code 28805 was associated with the second highest estimated probability of mortality of the cohort (0.0327±0.0596), with statistical significance less than that of CPT code 27245 (0.0327±0.0596 vs. 0.0547±0.0661; p<0.0001), but higher than all other CPT codes (p<0.001).

The study underscores that the transmetatarsal amputation carries a substantial risk for morbidity and mortality in comparison to other commonly performed surgical procedures. Through this analytical lens, Prof. Meyr and his team have provided a valuable addition to the existing literature, aiding in the continuous effort to improve surgical outcomes and patient care in the realm of diabetic limb preservation and partial foot amputation.

You can read the full manuscript here.

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