Mortalidade depois da amputação

Objectives

Estimate the frequency, risk factors and survival rate in amputated patients.

Methods

Retrospective single center analysis of the electronic clinical data of 297 consecutive patients who underwent amputation between January 2008 and August 2009. Time‐dependent event rates were estimated by the Kaplan‐Meier method. The differences between groups were evaluated with the Log Rang test. The age impact on mortality was estimated by a Cox regression model. A P value below 0,05 was considered statistically significant.

Results

The predominant surgery etiology was Peripheral Arterial Disease (87%). The survival rate at 30, 90, 365 days and at 5 years in patients who underwent minor amputation was 95% (EP = 0.02), 91% (EP = 0.03), 79% (EP = 0.04) e 55% (EP = 0.05) respectively. In patients who underwent major amputation was 82% (EP = 0.03), 70% (EP = 0.03), 62% (EP = 0.03) e 35% (EP = 0.03) respectively. The presence of ischemic heart disease and cerebrovascular disease had a significant impact as a predictive factor of less survival. There was a higher survival in diabetic patients. The mortality rate at 30, 90, 365 days and at 5 years was 12% (EP = 0.02), 23% (EP = 0.03), 33% (EP = 0.03) and 59% (EP = 0.03) respectively. A statistically significant association between age and mortality was seen (p< 0.05).

Conclusion

There is a high mortality rate in amputated patients, in the first 30 days, being always higher when major amputations are considered. We can associate these results to increasing aging population which carries more comorbidities and lower recoverability. However, we must reflect on the no less significant role of demand and access to specialized care.