Prevalence of Major Amputation in COVID-19 Era Compared to Non-COVID-19 Era- A Descriptive Retrospective Single Centre Study

Abstract

Introduction Amputation is the loss or removal of a body part such as a finger, toe, hand, foot, arm or leg. It can be a life changing experience affecting your ability to move, work, interact with others and maintain your independence. Continuing pain, phantom limb phenomena and emotional trauma can complicate recovery. Objective To assess the Prevalence of major amputation in covid-19 era compared to non-covid-19 era. Materials and Methods A descriptive Retrospective single Centre study was contacted in the Department Of Vascular Surgery, Ibrahim Cardiac Hospital And Research Institute, Shahbag, Dhaka, Bangladesh from Pre-pandemic era- 1st March 2018 to 3th August 2019: 18 months Group A and Pre-pandemic era- 1st March 2020 to 31th August 2021: 18 months Group B. We used the admission registers of all the hospital’s departments. We carried out a data collection sheet which allowed us to study the following parameters: the demographic aspects (age: according to WHO age groups and the sex of the patients), the type of amputation, the level of amputation and the causes. Results In the prepandemic phase, 18 major amputations were done (BK, 10 and AK, 8, and in the pandemic phase, 68 major amputations (BK, 53 and AK, 15) (P =.527) were undergone (fig-1). The age of the study participants in the prepandemic and pandemic period who had undergone a major amputation was 60.2 ± 13.4 and 62.88 ± 11.08 years (p=.241), respectively. The majority of the study participants were male in both the periods (prepandemic, M: F = 12:6; pandemic, M: F = 50:18) (P = .705). The mean duration of ulcer in the prepandemic period was 9 days and the same during the pandemic period was 10.8 days (P = .269). Co morbidities DM was present in 12(66.66%) study participants in the prepandemic and 40(58.82%) participants in the pandemic period (p=1.000). Diabetes Mellitus (DM) was present in 16 (88.88%) study participants in the prepandemic and 42(61.76%) participants in the pandemic period (p= 1.000). PAD was present in 16 (88.88%) and 38 (55.85%) study participants in the prepandemic and pandemic groups, respectively (p= .248). The amputation rate in the prepandemic and pandemic phases was 4.48 per 1000 and 10.30 per 1000, respectively (Table-1). The above chart shows distribution of complications after amputation. Presence of Ulcer was present in 16 study participants in the prepandemic and 34 participants in the pandemic period (p=0.006*). Acute Limb Ischemia was present in 1 study participants in the prepandemic and 10 participants in the pandemic period (p=1.000). Conclusion Number of major amputations increased a lot in COVID-19 era compared to non COVID-19 era due to lack of regular follow-up for this panic COVID situation. The prevalence of diabetes-related major amputations during the COVID-19 pandemic. From the results of this study, we observed there was a delay in seeking health care during the pandemic period when compared to the prepandemic period. Furthermore, these emphasize the need for easy and routine access to foot-care specialists to prevent avoidable amputations.