Does re-amputation following lower extremity amputation in diabetic or dysvascular patients negatively affect survival?

Abstract

Objective: We aimed to investigate the characteristics of patients who underwent unilateral amputation due to diabetes and peripheral artery disease, as well as the risk factors that cause re-amputation, and to determine these patients' survival status and the risk factors for mortality. Patients and Methods: This retrospective study included 133 patients who underwent amputation due to diabetes and peripheral arterial disease between 2012 and 2018. The etiology of amputation, the re-operation rate and time to re-operation following initial amputation, survival status and follow up results were accessed from hospital records. Results: Twenty-eight patients underwent amputation due to peripheral arterial disease, whereas 105 patients had peripheral vasculopathy due to diabetes mellitus. The re-operation rate was 33.8%, and the median period from initial surgery to the second surgery was six-weeks. Sixty-six deceased patients survived with a median of 6 months following initial operation. Conclusion: The most crucial factor causing re-amputation was the non-healing wound problems. Patients with amputation should be followed up carefully for wound problems in the six weeks after surgery. Advanced age, American Society of Anesthesiologist grade 4 patients, associating neurological disease, low albumin level, low lymphocyte count and postoperative intensive care unit requirement were all poor prognostic factors for survival. Re-amputation had no negative effect on survival.

The Relationship Between Diabetic Neuropathy and Uric Acid/High-Density Lipoprotein Ratio in Patients With Type-2 Diabetes Mellitus

“…About half of patients with DPDN are asymptomatic. It is the most critical cause of foot amputation, especially involving the lower extremities [ 2 , 3 ]. Hypotheses regarding the pathogenesis of diabetic neuropathy include activation of the polyol pathway, increased non-enzymatic glycation, vascular dysfunction, impaired lipid metabolism, and impaired neurotrophicity [ 4 ].…”