Preoperative risk factors for improved outcome in major limb amputations: In the perspective of anesthesiologists

Ceyhan H, Erkılıç E, Demirtola M, Kesimci E*, Gümüş T, Kanbak O and Aksoy M

Objective: Patients undergoing major limb amputations are often elderly, debilitated patients with comorbidities that increase their operative risks and postoperative morbidity and mortality rates. We, as anesthesiologists, aimed to underline the factors that are important in decision-making for the well-being of these patients in the preoperative period. 

Method: After Ethical Committee approval, data was collected retrospectively from files of patients who underwent major limb amputation surgeries in our hospital from January 2014 to March 2016. Patient characteristics, indications for amputation, anesthetic techniques and surgical procedures performed, perioperative complications, requirement of intensive care unit admissions, length of stay in Intensive Care Unit (LOS in ICU) and hospital together with mortality rates were recorded. The results were represented as numbers and percentage.

Results: A total of 126 patients were evaluated in the study. The mean age was 68.1±15.9 years. ASA IV patients made up 46% of all. 87.3% had emergency surgeries. The median waiting time before operation was 1 day (0-29). Mortality rate at 30-day was 9.5%. The median length of stay in ICU and hospital was 3(1-135) and 12(1-135) days, respectively. The length of time a patient waited after admission to hospital prior to the operation and LOS in ICU and hospital were found to have significantly adverse effects on survival. The re-amputated patients were the ones who had significantly longer preoperative waiting times and more postoperative complications.

Conclusion: We herein documented the data of patients undergoing major limb amputation including preoperative care and perioperative complications. We tried to draw attention to the appropriate perioperative preparation of these patients and its effects on the outcomes.

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Published on: Mar 16, 2020 Pages: 1-4

Full Text PDF Full Text HTML DOI: 10.17352/2455-3476.000049
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