Predictors of wound complications following major amputation for critical limb ischemia

Ravishankar Hasanadka, Robert Mclafferty, Colleen J. Moore, Douglas B. Hood, Don E. Ramsey, Kim J. Hodgson

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Objectives: For patients with end-stage critical limb ischemia (CLI) who have already suffered over an extended period of time, a major amputation that is free of wound complications remains paramount. Utilizing data from the American College of Surgeons, National Surgical Quality Improvement Program (ACS-NSQIP), the objective of this report was to determine critical factors leading to wound complications following major amputation. Methods: ACS-NSQIP was used to identify patients 2 increase in BMI). Mortality was 7.6% for BKAs and 12% for AKAs. Complete functional dependence was most predictive of mortality following AKA (P <.0001, OR 2.5). Medical comorbidities such as history of myocardial infarcation (MI) (OR 1.8), congestive heart failure (CHF, OR 1.6), and chronic obstructive pulmonary disease (COPD, OR 1.6) predicted mortality following BKA, while dialysis use (OR 2.4), CHF (OR 2.3), and COPD (OR 2.1) predicted mortality following AKA. Conclusions: Wound occurrences and mortality rates after major amputation for CLI continue to be a prevalent problem. Normalization of the INR prior to BKA should decrease WOs. Heightened awareness in higher risk patients with improved preventive measures, earlier disease recognition, better treatments, and increased education remain critical to improving outcomes in an already stressed patient cohort.

Original languageEnglish (US)
Pages (from-to)1374-1382
Number of pages9
JournalJournal of Vascular Surgery
Volume54
Issue number5
DOIs
StatePublished - Nov 2011
Externally publishedYes

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Amputation
Ischemia
Extremities
Mortality
Chronic Obstructive Pulmonary Disease
Wounds and Injuries
Quality Improvement
International Normalized Ratio
Comorbidity
Dialysis
Heart Failure
Education
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Predictors of wound complications following major amputation for critical limb ischemia. / Hasanadka, Ravishankar; Mclafferty, Robert; Moore, Colleen J.; Hood, Douglas B.; Ramsey, Don E.; Hodgson, Kim J.

In: Journal of Vascular Surgery, Vol. 54, No. 5, 11.2011, p. 1374-1382.

Research output: Contribution to journalArticle

Hasanadka, Ravishankar ; Mclafferty, Robert ; Moore, Colleen J. ; Hood, Douglas B. ; Ramsey, Don E. ; Hodgson, Kim J. / Predictors of wound complications following major amputation for critical limb ischemia. In: Journal of Vascular Surgery. 2011 ; Vol. 54, No. 5. pp. 1374-1382.
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