Major Lower Limb Amputations: Experience of a Tertiary Care Hospital in Sri Lanka.

Abstract

To determine the epidemiology and conditions frequently seen in major lower extremity amputation. Observational study. Teaching Hospital Karapitiya, Sri Lanka, from October 2013 to September 2014. Major lower limb amputations were identified according to ICD-10 criteria. Data was retrospectively collected. Type of the amputation, indication for the amputation, gender and age of the patients, and mortality were noted. Eighty-five cases of major lower limb amputations were analyzed, including 43 above-knee amputations, 40 below-knee amputations, and 2 through-knee amputations. Most of the patients were in their 7th (38.8%, n=33) and the 8th (21%, n=18) decade of life. Female to male ratio was 1:1.7. Indications of lower extremity amputation were diabetic foot ulcer (37.6%, n=32), peripheral vascular disease (31.7%, n=27), followed by trauma (n=6), acute limb ischemia and infections (n=5 each), chronic osteomyelitis (n=4), tumors (n=3), elephantiasis, pressure sore and chronic wound (n=1 each). Overall diabetes frequency was 52.9% (n=45). In-hospital mortality rate was 9.4%. Main cause of deaths was septicemia. In the study population, major lower limb amputations were more common in males compared to females, with highest incidence in the 7th and 8th decades. Diabetes mellitus contributed to more than 50% of amputations directly or indirectly, and septicemia was responsible for the most mortality.