Annals of Vascular Surgery
Volume 20, Issue 2 , Pages 209-216 , March 2006

Factors Affecting Perioperative Mortality and Wound-Related Complications Following Major Lower Extremity Amputations

  • Patrick A. Stone, MD

      Affiliations

    • Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
    • Corresponding Author InformationCorrespondence to: Patrick A. Stone, MD, Vascular Section, Department of Surgery, West Virginia University-Charleston Division, 3100 MacCorkle Avenue SE, Suite 603, Charleston, WV, 25304, USA
    • ,
  • Sarah K. Flaherty, BS

      Affiliations

    • Charleston Area Medical Center Health Education and Research Institute, Charleston, WV, USA
    • ,
  • Ali F. AbuRahma, MD, FACS, FRCS

      Affiliations

    • Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
    • ,
  • Stephen M. Hass, MD

      Affiliations

    • Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
    • ,
  • J. Michelle Jackson, DO

      Affiliations

    • Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
    • ,
  • J. David Hayes, MD

      Affiliations

    • Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
    • ,
  • Matthew J. Hofeldt, MD

      Affiliations

    • Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
    • ,
  • Casey S. Hager, MD

      Affiliations

    • Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA
    • ,
  • Michael S. Elmore, MD

      Affiliations

    • Department of Surgery, West Virginia University-Charleston Division, Charleston, WV, USA

REFERENCES 

  1. Feinglass J , Brown JL , LoSasso A , et al.   Rates of lower extremity amputation and arterial reconstruction in the United States, 1979 to 1996 . Am J Public Health . 1999;89:1222–1227
  2. Aulivola B , Hile CN , Hamdan AD , et al.   Major lower extremity amputation: outcome of a modern series . Arch Surg . 2004;139:395–399
  3. Sandnes DK , Sobel M , Flum DR . Survival after lower-extremity amputation . J Am Coll Surg . 2004;199:394–402
  4. Nehler MR , Coll JR , Hiatt WR , et al.   Functional outcome in a contemporary series of major lower extremity amputations . J Vasc Surg . 2000;38:7–14
  5. Cruz CP , Eidt JF , Capps C , Kirtley L , Moursi MM . Major lower extremity amputations at a Veterans Affairs hospital . Am J Surg . 2003;186:449–454
  6. Rutherford RB , Baker JD , Ernst C , et al.   Recommended standards for reports dealing with lower extremity ischemia: revised version (SVS/ISCVS Clinical Categories of Acute Limb Ischemia) . J Vasc Surg . 1997;26:517–538
  7. Rubin JR , Marmen C , Rhodes RS . Management of failed prosthetic grafts at the time of major lower extremity amputation . J Vasc Surg . 1988;7:673–676
  8. Collins TC , Johnson M , Daley J , Henderson WG , Khuri SF , Gordon HS . Preoperative risk factors for 30-day mortality after elective surgery for vascular disease in Department of Veterans Affairs hospitals: is race important? . J Vasc Surg . 2001;34:634–640
  9. Felix WR , Sigel B , Gunther L . The significance for morbidity and mortality of Doppler-absent pedal pulses . J Vasc Surg . 1987;5:849–855
  10. Yeager RA , Moneta GL , Taylor LM , Hamre DW , McConnell DB , Porter JM . Surgical management of severe acute lower extremity ischemia . J Vasc Surg . 1992;15:385–393
  11. Campbell WB , Marriott S , Eve R , Mapson E , Sexton S , Thompson JF . Amputation for acute ischemia is associated with increased comorbidity and higher amputation level . Cardiovasc Surg . 2003;11:121–123
  12. Harpole DH , DeCamp MM , Daley J , et al.   Prognostic models of thirty-day mortality and morbidity after major pulmonary resection . J Thorac Cardiovasc Surg . 1999;117:969–979
  13. Rady MY , Ryan T , Starr NJ . Perioperative determinants of morbidity and mortality in elderly patients undergoing cardiac surgery . Crit Care Med . 1998;26:225–235
  14. Longo WE , Virgo KS , Johnson FE , et al.   Risk factors for morbidity and mortality after colectomy for colon cancer . Dis Colon Rectum . 2000;43:83–91
  15. Braga M , Gianotti L , Nespoli L , et al.   Nutritional approach in malnourished surgical patients: a prospective randomized study . Arch Surg . 2002;137:174–180
  16. Back MR , Stordahl N , Cuthbertson D , Johnson BL , Bandyk DF . Limitations in the cardiac risk reduction provided by coronary revascularization prior to elective vascular surgery . J Vasc Surg . 2002;36:526–533
  17. Eagle KA , Rihal CS , Mickel MC , Holmes DR , Foster ED , Gersh BJ . Cardiac risk of noncardiac surgery: influence of coronary artery disease and type or surgery in 3368 operations. CASS Investigators and the University of Michigan Heart Care Program. Coronary Artery Surgery Study . Circulation . 1997;96:1882–1887
  18. McFalls EO , Ward HB , Moritz TE , et al.   Coronary-artery revascularization before elective major vascular surgery . N Engl J Med . 2004;351:2795–2804
  19. Keagy BA , Schwartz JA , Kotb M , Burnham SJ , Johnson G . Lower extremity amputations: the control series . J Vasc Surg . 1986;4:321–326
  20. Miller N , Dardik H , Wolodiger F , et al.   Transmetatarsal amputation: the role of adjunctive revasularization . J Vasc Surg . 1991;13:705–711
  21. Bailey MJ , Johnston CL , Yates CJ , Somerville PG , Dormandy JA . Preoperative haemoglobin as predictor of outcome of diabetic amputations . Lancet . 1979;2:168–170
  22. Eneroth M , Persson BM . Risk factors for failed healing in amputation for vascular disease. A prospective, consecutive study of 177 cases . Acta Orthop Scand . 1993;64:369–372
  23. Buggy D . Can anesthetic management influence surgical wound healing? . Lancet . 2000;356:355–357
  24. Allen DB , Maguire JJ , Mahdavian M , et al.   Wound hypoxia and acidosis limit neutrophil bacterial killing mechanisms . Arch Surg . 1997;132:991–996
  25. McBride WT , Armstrong MA , McBride SJ . Immunomodulation: an important concept in modern anaesthesia . Anaesthesia . 1996;51:465–473
  26. Ballantyne JC , Carr DB , deFerranti S , et al.   The comparative effects of postoperative analgesic therapy on pulmonary outcome: cumulative analysis of randomized controlled trials . Anesth Analg . 1998;86:598–612

 Presented at the 33rd Annual Symposium: Society for Clinical Vascular Surgery, Coral Gables, FL, March 2005.

PII: S0890-5096(06)60033-2

doi: 10.1007/s10016-006-9009-z

Annals of Vascular Surgery
Volume 20, Issue 2 , Pages 209-216 , March 2006

Article Tools