Long-term mortality after lower extremity amputation: A retrospective study at a second-level government hospital in Cape Town, South Africa

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Long-term mortality after lower extremity amputation: A retrospective study at a second-level government hospital in Cape Town, South Africa


JournalEast and Central African Journal of Surgery
Article typeJournal research article – Clinical research
Publication date – Jan – 2021
Authors – Salah Rodwan Husein, Megan Naidoo, Heather Bougard, MBChB, Kathryn M. Chu
Keywordsamputation, health systems strengthening, post-operative mortality, surgery
Open access – Yes
SpecialityTrauma and orthopaedic surgery, Vascular surgery
World region Southern Africa
Country: South Africa
Language – English
Submitted to the One Surgery Index on January 30, 2021 at 6:56 am
Abstract:

Background:
Long-term mortality after lower extremity amputation (LEA) is not well reported in low- and middle-income countries. The primary aim of this study was to report 30-day and one-year mortality after LEA in South Africa. The secondary objective was to report risk factors for one-year mortality.
Methods:
This was a retrospective study of patients undergoing LEA at New Somerset Hospital, a second-level government facility in Cape Town, South Africa from October 1, 2015 to October 31, 2016. A medical record review was undertaken to identify co-morbidities, operation details, and perioperative mortality rate. Outcome status was defined as alive, dead, or lost to follow-up. Outcomes at 30 days and one-year were reported.
Results:
There were 152 patients; 90 (59%) males and the median age was 60 years. Co-morbidities were available for 137 (90%). One hundred and eight (79%) had peripheral vascular disease and 91 (66%) had diabetes mellitus. Fifty-three (35%) had more than one LEA on the same or contralateral limb. There were 183 LEAs in 152 patients. The most common LEA was above knee amputation (n=104, 57%) followed by below-knee amputation (n=36, 20%). At 30 days, 102 (67%) of 152 were traced and 12 (12%) were dead. At one year, 86 (57%) were traced and 37 (43%) were dead.
Conclusions:
At this second-level South African hospital, 43% of patients undergoing LEA were dead after one year. In resource-constrained settings, mortality data are necessary when considering resource allocation for LEA and essential surgical care packages.

OSI Number – 20903

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