Abstract
Patients requiring major lower extremity amputation may be afflicted with severe comorbidities that increase the risk of postoperative mortality. The aim of this retrospective pilot study was to identify the risk factors of hospital mortality following major lower extremity amputations in patients with significant comorbidities such as diabetes mellitus (DM) or severe atherosclerosis obliterans (ASO). The study population consisted of 36 patients with DM and/or ASO who underwent either above knee (n = 15) or below knee amputation (n = 21). Demographic and clinical data, perioperative data, postoperative complications, and mortality were recorded from medical and anesthetic records. Thirty-day postoperative mortality was 8.3% (n = 3) and total hospital mortality was 30.6% (n = 11). All hospital deaths occurred within 1 year. Low preoperative serum albumin and postoperative blood transfusions were independent risk factors of hospital mortality (P < 0.05). In conclusion, the patients with ASO and DM are at high risk of hospital mortality following lower extremity amputation, particularly in cases with preoperative hypoalbuminemia or cases requiring postoperative blood transfusion. Because of the small sample size, further prospective studies are needed to confirm our findings.
