Taylor et al evaluated patients after major lower limb amputation. They identified preoperative clinical factors associated with postoperative disability. The authors are from Greenville Hospital System and Clemson University.
Patient selection: major lower limb amputation
Outcome: functional ability
Risk factors associated with poor functional outcome after amputation:
(1) age >= 70 years of age (Table IV indicates >= 60 may also be a valid cut-off)
(2) dementia
(3) end-stage renal disease (ESRD)
(4) advanced coronary artery disease
(5) limited mobility prior to surgery
An above-the-knee amputation should be considered for a patient with:
(1) a patient who is bedridden prior to surgery
(2) a patient with one or more of the above risk factors
A young patient with none of the risk factors can be expected to have a functional outcome after a below-the-knee amputation that is comparable to that after a successful lower limb revascularization procedure.
