Amputations in peripheral vascular occlusive disease

Berardi, Romeo S.; Keonin, Yotin

doi:10.1016/0002-9610(78)90106-x

Cited by 33 publications

(6 citation statements)

References 7 publications

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“…Few were able to walk, and many had problems carrying out essential tasks of living, as has been reported in similar studies 38,46,47 . In some settings, however, rehabilitation has been more successful 22,33,48–50 . Few authors have considered quality of life other than walking.…”

Section: Discussionmentioning

confidence: 87%

“…High postoperative complication rates, including infection, have been previously reported 20–24 . Significantly associated with postoperative complications was hypocalcemia, a marker for hypoalbuminemia in the critically ill. Hypocalcemia, per se, should be further evaluated by a serum ionized calcium measurement before instituting therapy 25 .…”

Section: Discussionmentioning

confidence: 93%

“…Death after lower extremity amputation from sepsis or circulatory problems has been extensively discussed in the literature 1,21,22,30,40 . Reports indicate that one third are dead by the second year and two thirds within 5 years 21, 22, 42 .…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Lower Extremity Amputations

Weiss¹,

Gorton

Read

et al. 1990

J American Geriatrics Society

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In an effort to identify variables that could be used to predict outcomes of amputation, a cohort of 97 veteran amputees with a median age of 64 years who underwent 155 lower extremity procedures during 1984 was followed for 15 months. A high incidence of postoperative complication, revision, and mortality with poor quality of life confirm the serious prognosis of these individuals. Regression analyses indicated that peripheral vascular disease and prolonged preoperative hospitalization were associated with complications. Preoperative gangrene and peripheral vascular disease were associated with the need for revision. Complications, a low body mass index, and multiple diseases were related to death. Those with multiple diseases and extensive atherosclerosis were less likely to walk. Ability to perform activities of daily living was the most important predictor of quality of life. Patients at higher risk for these adverse outcomes need to be identified early in their hospital stay. The involvement of the patient or his or her surrogate in decisions regarding the course of treatment and the level of amputation is essential.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 93%

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Outcomes of Lower Extremity Amputations

Weiss¹,

Gorton

Read

et al. 1990

J American Geriatrics Society

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“…Infection plays a major role in morbidity, hospitalisation and amputation, but is not stated as a component for the development of diabetic foot disease. After St. Vince Declaration setting a 5-year target of decreasing by half the leg amputation rate in diabetic patients [4], several studies have established the importance of multidisciplinary approach to diabetic foot lesions [5,6]. We have previously shown the effectiveness of team working in diabetic foot disease and reported the risk factors of amputation in hospitalised patients due to diabetic foot disease [7].…”

Section: Introductionmentioning

confidence: 99%

Change in amputation predictors in diabetic foot disease: effect of multidisciplinary approach

Aydín

Işıldak

Karakaya

et al. 2010

Endocr

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Diabetic foot disease causes important morbidity in diabetic population, and amputation due to diabetic foot disease occurs more often than in general population. We have been evaluating patients with diabetic foot disease in a multidisciplinary approach since year 2000. In the current study, we sought to investigate the change in amputation rate and its predictors in diabetic foot with a multidisciplinary team approach. Seventy-four patients (52 male, 22 female) hospitalised between January 2002 and December 2007 were retrospectively analysed. Sixteen out of 74 have undergone amputation. We found overall amputation rate as 21.6%, which is lower than previously reported from our institution (36.7 and 39.4%, respectively). Major amputations (syme, below-knee, above-knee) were applied to 11 patients (14.9%). A logistic regression model including osteomyelitis, peripheral neuropathy, peripheral vascular disease, hypertension, gangrene and age revealed that gangrene is now the only significant predictor for amputation. Our observations confirm that amputation rate has declined after implementation of a multidisciplinary team work, and risk factors apart from presence of gangrene are no longer amputation predictors in our centre.

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“…Poor skin perfusion has been responsible for failure rates as high as 50 percent following lower limb amputations in patients with occlusive arterial curate determination of such flow would greatly reduce morbidity and associated hospital costs (1)(2)(3)(4)(5)(6)(7)(8). Unfarl means of assessing skin perfusion has gained widespr acceptance.…”

Section: Introductionmentioning

confidence: 99%

Flemorometuic Prediction of Successful Amputation Level in the Ischemic Limb

Silverman¹,

Rubin²,

Reilly³

et al. 1985

JRRD

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-The present study was undertaken to compare fluorometric documentation of fluorescein dye delivery with the standard means of determining the level at which an amputation should be performed in the dysvascular extremity. Thirty-nine patients underwent lower-extremity amputation at the level determined by the surgeon based upon physical examination, angiography, segmental pressure indices, andlor pulse volume recordings. In addition, fiberoptic fluorometry was performed preoperatively. After intravenous administration of sodium fluorescein (4-8 mglkg), fluorometric readings were obtained by placing the fluorometer's light guide on 126 reading sites. Fluorometric findings were evaluated retrospectively, and therefore did not influence the surgeon's decision.Of the 39 amputations performed overall, only 26 healed. The accuracy of the standard criteria was lowest for the 20 below-ankle amputations, where only 12 cases healed. Alternatively, fluorometric indices separated healing from nonhealing sites in 36 of the 39 cases and in 18 of the 20 below-ankle amputations. Overall, healing sites averaged 94 percent of the fluorescence of the healthy reference area, while nonhealing sites averaged only 29 percent. We conclude that fluorometry should prove to be a valuable adjunct in the assessment of the dysvascular extremity. It uses a low dose of dye, is easy to perform, and is readily repeatable.

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Amputations in peripheral vascular occlusive disease

Cited by 33 publications

References 7 publications

Outcomes of Lower Extremity Amputations

Outcomes of Lower Extremity Amputations

Change in amputation predictors in diabetic foot disease: effect of multidisciplinary approach

Flemorometuic Prediction of Successful Amputation Level in the Ischemic Limb

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