Description

Perkins et al reported factors associated with amputation following surgical repair of lower extremity vascular trauma. The authors are from the University of London.


Patient selection: status post repair of vascular trauma in the lower extremity

 

Outcome: secondary amputation

 

Predictive factors for amputation:

(1) major soft tissue injury (odds ratio 5.8)

(2) compartment syndrome (odds ratio 5.1)

(3) multiple arterial injuries (odds ratio 4.9)

(4) duration of ischemia > 6 hours (odds ratio 4.4)

(5) associated fracture (odds ratio 4.3)

(6) mechanism of injury blast or blunt injury (vs penetrating)

(7) anatomic site of injury iliac, popliteal or tibial vs femoral

(8) age > 55 years (odds ratio 3.0)

(9) female sex (odds ration 1.6)

 

The risk of amputation increases with the number of factors present.

 

Factors previously reported as significant but not significant in the study:

(1) shock

(2) major nerve injury

(3) major venous injuries


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