North American Journal of Medical Sciences

ORIGINAL ARTICLE
Year
: 2014  |  Volume : 6  |  Issue : 7  |  Page : 321--327

Chronic kidney disease predicts long-term mortality after major lower extremity amputation


Roland Assi1, Yorg Al Azzi2, Clinton D Protack1, Willis T Williams1, Michael R Hall1, Daniel J Wong4, Daniel Y Lu4, Penny Vasilas3, Alan Dardik1 
1 Department of Surgery, Department of Veterans Affairs Connecticut Healthcare System, West Haven; Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
2 Department of Medicine, Mount Sinai Hospital, Icahn School of Medicine, New York, USA
3 Department of Surgery, Department of Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut, USA

Correspondence Address:
Alan Dardik
VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, Connecticut - 06516
USA

Background: Despite low peri-operative mortality after major lower extremity amputation, long-term mortality remains substantial. Metabolic syndrome is increasing in incidence and prevalence at an alarming rate in the USA. Aim: This study was to determine whether metabolic syndrome predicts outcome after major lower extremity amputation. Patients and Methods: A retrospective review of charts between July 2005 and June 2010. Results: Fifty-four patients underwent a total of 60 major lower extremity amputations. Sixty percent underwent below-knee amputation and 40% underwent above-knee amputation. The 30-day mortality was 7% with no difference in level (below-knee amputation, 8%; above-knee amputation, 4%; P = 0.53). The mean follow-up time was 39.7 months. The 5-year survival was 54% in the whole group, and was independent of level of amputation (P = 0.24) or urgency of the procedure (P = 0.51). Survival was significantly decreased by the presence of underlying chronic kidney disease (P = 0.04) but not by other comorbidities (history of myocardial infarction, P = 0.79; metabolic syndrome, P = 0.64; diabetes mellitus, P = 0.56). Conclusion: Metabolic syndrome is not associated with increased risk of adverse outcomes after lower extremity amputation. However, patients with chronic kidney disease constitute a sub-group of patients at higher risk of postoperative long-term mortality and may be a group to target for intervention.


How to cite this article:
Assi R, Al Azzi Y, Protack CD, Williams WT, Hall MR, Wong DJ, Lu DY, Vasilas P, Dardik A. Chronic kidney disease predicts long-term mortality after major lower extremity amputation.North Am J Med Sci 2014;6:321-327


How to cite this URL:
Assi R, Al Azzi Y, Protack CD, Williams WT, Hall MR, Wong DJ, Lu DY, Vasilas P, Dardik A. Chronic kidney disease predicts long-term mortality after major lower extremity amputation. North Am J Med Sci [serial online] 2014 [cited 2021 Oct 23 ];6:321-327
Available from: https://www.najms.org/article.asp?issn=1947-2714;year=2014;volume=6;issue=7;spage=321;epage=327;aulast=Assi;type=0