title: Non traumatic lower extremity amputations in younger patients: an 11-year retrospective study.
abstract: The purpose of this study was to assess morbidity and mortality in patients undergoing non traumatic lower extremity amputations ≤65 years to identify the specific needs of these younger patients. A retrospective study was conducted to determine the demographics, comorbidity and mortality with below-knee amputations and above-knee amputations from 1998 to 2008. A total of 203 amputations were performed on 176 patients who were ≤65 years. Major comorbidities and associated physical findings were peripheral vascular disease, diabetes, pain, gangrene, hypertension, ulcer, local wound infection and hypercholesterolemia. Compared to patients who were not deceased post-amputation, those deceased had a higher prevalence of diabetes, renal failure, coronary artery disease (CAD) and sepsis. Significant predictors of mortality were renal failure (hazard ratio [HR] = 4·19; 95% CI 1·96-8·93), CAD (HR = 3·33; 95% CI 1·42-7·81) and amputation site (above-knee) (HR = 3·26; 95% CI 1·51-7·04). This study showed that younger patients may benefit from an interdisciplinary approach in treating local foot ulcers aggressively and optimising their cardiovascular, renal and diabetic risk factors.
authors.affiliation: University of Toronto, Division of Plastic Surgery/Wound Care, St. Michael's Hospital, Toronto, ON, Canada. jessica.chin@utoronto.ca
authors.forename: Jessica W S
authors.initials: JW
authors.lastname: Chin
authors.forename: Laura
authors.initials: L
authors.lastname: Teague
authors.forename: Ann-Marie
authors.initials: AM
authors.lastname: McLaren
authors.forename: James L
authors.initials: JL
authors.lastname: Mahoney
mesh_terms: D000367:Age Factors; D000671:Amputation, Surgical / Q000401:mortality / Q000706:statistics & numerical data*; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D017719:Diabetic Foot / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007866:Leg / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009864:Ontario / Q000453:epidemiology; D016491:Peripheral Vascular Diseases / Q000401:mortality / Q000601:surgery*; D015995:Prevalence; D016016:Proportional Hazards Models; D051437:Renal Insufficiency / Q000453:epidemiology / Q000401:mortality / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors