The eventual outcome of patients who had lower limb amputations due to peripheral vascular disease at Pelonomi Hospital, Bloemfontein

Abstract

Background: Peripheral vascular disease (PVD) presenting with irreversible lower limb pathology has a high morbidity and mortality rate. This study aimed to determine the outcome of patients who underwent lower limb amputations (LLAs) because of PVD at Pelonomi Hospital, Bloemfontein, 2008-2011. Methods: Prospective data collection of a retrospective cohort study group was performed. Included were patients with PVDinduced LLAs. Demographic and contact information was collected from Meditech. Living status (alive or dead) was determined using the Department of Home Affairs database and interviews with relatives. Results: Of the study population (n = 224), 119 had contact information. Data of 158 people were available to determine living status: 71.5% had died by follow-up in 2014. Forty-nine interviews were possible, 31 patients had died, with cause of death reported to be primarily vascular related. The cumulative mortality showed that 16.1% died within a month and 48.4% within one year post-amputation. Among the 18 living amputees, 50.0% became unemployed, 77.8% used wheelchairs, 11.1% used crutches and 11.1% a prosthesis. Conclusion: Lower limb amputation due to PVD is indicative of a poor prognosis. In our study only 28.5% of patients survived 3-6 years post-amputation. Restoration to ideal mobility was achieved in a minority of cases. Keywords Bloemfonteinlower limb amputationspatient outcomeperipheral vascular disease

Lower limb amputations among individuals living with diabetes mellitus in low- and middle-income countries: A systematic review protocol

“…LLA poses a substantial health, psychological [ 7 ] and socio-economic burden, both at individual and country level [ 8 – 10 ], and greatly affects quality of life [ 11 ]. It is also associated with disability and premature mortality [ 12 ]. In 2016, there were an estimated 1.5 million years lived with disability (YLD) resulting from amputations, a 32% increase from 1990 [ 13 ].…”

Prosthetic use by persons with unilateral transfemoral amputation in a South African setting

“…6 However, transfemoral prosthetic mobility can be challenging, 7,8 and not all will be able to walk with a prosthesis. 9,10 Due to the loss of the normal knee joint, transfemoral prosthetic mobility is more challenging than transtibial prosthetic mobility as energy demands increases, along with dynamic balance and strength demands. [11][12][13] Hagberg and Branemark 14 showed that users of transfemoral prostheses can often only walk short distances before they have to stop and are often reliant on additional hand-held walking devices.…”

“…14,15 Studies from developed countries reported that 75%-87% of participants used their prosthesis daily. 13,14,16 From South Africa, De Klerk et al 10 reported that 11.1% of participants used a prosthesis for mobility while a study from Nigeria showed that only 7% (56) of people used their prosthesis. 17 Prosthetic use and mobility may be affected by intrinsic factors, such as cause and level of amputation, condition, strength and mobility of the residual limb, cardiovascular fitness, dynamic balance and pre-morbid mobility.…”

“…Studies from developed countries reported that 75%–87% of participants used their prosthesis daily. 13,14,16 From South Africa, De Klerk et al 10 reported that 11.1% of participants used a prosthesis for mobility while a study from Nigeria showed that only 7% (56) of people used their prosthesis. 17…”

Transtibial Osseointegration for Patients with Peripheral Vascular Disease

“…The rates of mortality after major amputation have been reported to be 44%, 66%, and 85% after 1, 3, and 5 years, respectively 9 , 10 . The high rate of 1-year mortality is usually from associated stroke or myocardial infarction (MI) 11 - 15 . Studies investigating health-related quality of life (QoL) in patients with PVD have revealed that QoL is primarily determined by mobility impairment 16 , 17 .…”