Abstract
【Purpose】The amputation rate of patients with peripheral arterial disease was reported to be high, although the opportunity of rehabilitation has increased. However, few studies have investigated the characteristics of patients with limb loss after undergoing minor amputation. The purpose of this study was to identify the incidence rate and risk factors for ipsilateral lower limb loss within 90 days of forefoot amputation.【Methods】In this retrospective cohort study, we identified 194 patients who had undergone minor amputations on 221 lower limbs from April 2003 to December 2005. Patients were divided into two groups according to initial minor amputation level, interphalangeal or transmetatarsal. The lower limb loss rate was compared using the Kaplan-Meier method and log-rank tests. Multivariate analysis was performed to identify predictors of lower limb loss.【Results】The incidence rate of lower limb loss within 90 days of prior amputation were significantly higher in the transmetatarsal group than in the interphalangeal group. Transmetatarsal amputation and serum CRP levels 6.0 mg/dL were identified as risk factors of lower limb loss after minor amputation.【Conclusion】The present results suggest the need of a rehabilitation program for patients who undergo transmetatarsal amputation or have high CRP level.
