Risk Factors for Early Lower Limb Re-Amputation in Vascular Diseases

Abstract

Numerous risk factors for lower limb amputations are known; however, this study aimed to identify risk factors for re-amputation in patients within 6months from an initial lower limb amputation procedure. This single-center retrospective cohort study was performed at the Hospital Regional Hans Dieter Schmidt in Brazil. The study included patients who were aged at least 18years and had undergone lower limb amputation between 2013 and 2022. Patients who died while hospitalized and patients who were lost to follow-up after hospital discharge were excluded from the study. Patient age, sex, number of amputations, revision time, comorbidities, and potential risk factors were extracted from the physical therapy service database and electronic medical records of the hospital. Chi-squared test and student's t-test were used to identify statistical significance. A total of 652 patients were included, of which 35.2% (230) patients underwent re-amputation within 6months of the first operation. We found that dialysis (P=0.004; odds ratio [OR] 8.36, 95% confidence interval [CI] 3.09-20.5), smoking (P=0.004; OR 1.67, 95% CI 1.18-2.35), and hypertension (P=0.02; OR 1.55, 95% CI 1.09-2.19) were predictive factors for re-amputation within 6months of lower limb amputation. Therefore, it is important to intervene early and provide additional support to patients undergoing lower limb amputation with these risk factors to reduce the potential for re-amputation in the future.