TH1.14 Major limb amputation during the Covid-19 pandemic – Have we seen a change in practice?

Abstract

IntroductionThere have been significant changes in the delivery of health care as a consequence of the Covid-19 pandemic. Standard operating procedures have been re-defined to minimise harm from the reduction in access to services, whilst at the same time protecting hospitals (and in particular critical care units) from admissions.We have explored major limb amputation (MLA) practice and compared this with a historical series.MethodsRetrospective review of major limb amputations (March 2019 to October 2021). Historical datasets have also been scrutinised (2008–2010). Specific variables of interest included the annual number of major limb amputations, primary versus secondary amputation and ratio of transtibial (TTA) to transfemoral (TFA) amputations.ResultsA complete dataset was available for 282 patients during the Covid period. Patient demographics were as anticipated - 206 (73%) male, mean age 63-years (range 23 to 90-years). Peripheral arterial disease (190) and diabetes mellitus (149) were common. These demographics were comparable to the historical data. The annual number of MLA has not changed over the Covid period. The ratio of primary to secondary MLA was 1:1.3 in the historical series and 1:1 during the Covid period. The ratio of TTA to TFA was 3:1.8 in the historical series and 2:1 during the Covid period.ConclusionThe trends suggest that practice has not changed significantly during the Covid period. There has been a slight change in the ratio of transtibial to transfemoral amputation, which may reflect patients presenting with later stage disease.