Description

Phair et al evaluated patients who underwent a major lower extremity amputation. They identified risk factors associated with unplanned readmission and stump complications. The authors are from Montefiore Medical Center and Massachusetts General Hospital.


Patient selection: below-the-knee (BKA) or above-the-knee (AKA)

 

30-day readmission rate: 29%

Stump complication rate: 8%

 

Stump complications:

(1) ischemia requiring above-the-knee amputation

(2) surgical site infection

(3) other wound problems

 

Non-stump complications:

(1) urinary tract infection

(2) pressure ulcer

(3) pneumonia

(4) Clostridium difficile disease

(5) congestive heart failure

(6) cardiac complications

(7) diabetes-related complications

 

Risk factors for stump complications requiring surgery:

(1) BKA

(2) rest pain as the indication for surgery

(3) occluded bypass graft

 

Risk factors for unplanned readmission:

(1) end-stage renal disease (ESRD)

(2) ASA 4

(3) coronary artery disease


To read more or access our algorithms and calculators, please log in or register.