Risk factors and rates of revision amputation following ischemic lower major limb amputations: A 10-year retrospective analysis

• Published in: Joint diseases and related surgery 2025-01, Vol.36 (1), p.174-181
• Main Authors: Selçuk, Eşref, Erem, Murat, Yıldırım, Savaş, Çopuroğlu, Cem, Çiftdemir, Mert, Erkal, Doğukan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Amputation, Surgical - adverse effects; Amputation, Surgical - statistics & numerical data; Female; Humans; Ischemia - epidemiology; Ischemia - surgery; Lower Extremity - blood supply; Lower Extremity - surgery; Male; Middle Aged; Peripheral Arterial Disease - epidemiology; Peripheral Arterial Disease - surgery; Reoperation - statistics & numerical data; Retrospective Studies; Risk Factors
• ISSN: 2687-4784; 2687-4792; 2687-4792
• DOI: 10.52312/jdrs.2025.2030

This study aimed to evaluate the rates and risk factors associated with revision amputation following ischemic lower major limb amputations, focusing on cases related to peripheral arterial disease. This retrospective study included 253 patients (174 males, 79 females; mean age: 73.1±12.2 years; range, 44 to 99 years) who underwent ischemic foot amputation between December 2012 and December 2022. Eligible patients were over 18 years old and had major lower extremity amputations due to peripheral arterial disease or chronic arterial occlusion. Exclusions were made for amputations due to diabetic foot conditions, trauma, tumors, or osteomyelitis and minor lower extremity amputations. Above-knee amputations were the most common type of amputation, accounting for 56.5% (n=143) of cases. Revision amputations occurred in 27.3% (n=69) of patients, with significantly higher rates in those with open wounds at first admission (chi-square [χ ]=9.81, p=0.002). Patients with occlusion at the popliteal artery level had a higher rate of revision amputation following below-knee amputation (p=0.034). Each additional year of age decreased the likelihood of revision amputation by 2.3% (p=0.049). Vacuum-assisted closure therapy was associated with higher revision rates (χ =22.71, p