Major lower extremity amputations - risk of re-amputation, time to re-amputation, and risk factors: a nationwide cohort study from Denmark.

IF 2.5 2区 医学 Q1 ORTHOPEDICS
Anna Trier Heiberg Brix, Katrine Hass Rubin, Tine Nymark, Hagen Schmal, Martin Lindberg-Larsen
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Abstract

Background and purpose: Re-amputation after lower extremity amputation is frequent. The primary aim of our study was to investigate cumulative re-amputation risk after transtibial amputation (TTA), knee disarticulation (KD), and transfemoral amputation (TFA) and secondarily to investigate time to re-amputation, and risk factors.

Methods: This observational cohort study was based on data from the Danish Nationwide Health registers. The population included first-time major lower extremity amputations (MLEA) performed in patients ≥ 50 years between 2010 and 2021. Both left and right sided MLEA from the same patient were included as index procedures.

Results: 11,743 index MLEAs on 10,052 patients were included. The overall cumulative risks for re-amputation were 29% (95% confidence interval [CI] 27-30), 30% (CI 26-35), and 11% (CI 10-12) for TTA, KD, and TFA, respectively. 58% of re-amputations were performed within 30 days after index MLEA. Risk factors for re-amputation within 30 days were dyslipidemia (hazard ratio [HR] 1.2, CI 1.0-1.3), renal insufficiency (HR 1.2, CI 1.1-1.4), and prior vascular surgery (HR 1.3, CI 1.2-1.5).

Conclusion: The risk of re-amputation was more than twice as high after TTA (29%) and KD (30%) compared with TFA (11%). Most re-amputations were conducted within 30 days of the index MLEA. Dyslipidemia, renal insufficiency, and prior vascular surgery were associated with higher risk of re-amputation.

重大下肢截肢--再次截肢的风险、再次截肢的时间和风险因素:一项来自丹麦的全国性队列研究。
背景和目的:下肢截肢后再次截肢的情况很常见。我们研究的主要目的是调查经胫骨截肢(TTA)、膝关节离断(KD)和经股骨截肢(TFA)后的累积再截肢风险,其次是调查再截肢的时间和风险因素:这项观察性队列研究基于丹麦全国健康登记数据。研究对象包括2010年至2021年期间首次接受主要下肢截肢手术(MLEA)且年龄≥50岁的患者。同一患者的左侧和右侧下肢截肢手术均被列为指数手术:结果:共纳入了10,052名患者的11,743例MLEA指数。TTA、KD和TFA再次截肢的总体累积风险分别为29%(95%置信区间[CI] 27-30)、30%(CI 26-35)和11%(CI 10-12)。58%的再次截肢是在指数 MLEA 后 30 天内进行的。30天内再次截肢的风险因素为血脂异常(危险比[HR]1.2,CI 1.0-1.3)、肾功能不全(HR 1.2,CI 1.1-1.4)和既往接受过血管手术(HR 1.3,CI 1.2-1.5):TTA(29%)和KD(30%)术后再次截肢的风险是TFA(11%)的两倍多。大多数再截肢手术都是在MLEA术后30天内进行的。血脂异常、肾功能不全和既往接受过血管手术与再次截肢的风险较高有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Acta Orthopaedica
Acta Orthopaedica 医学-整形外科
CiteScore
6.40
自引率
8.10%
发文量
105
审稿时长
4-8 weeks
期刊介绍: Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.
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