Postoperative and late survival outcomes after major amputation: findings from the Department of Veterans Affairs National Surgical Quality Improvement Program.

摘要: Abstract Background. A surgical risk model is used to analyze postoperative mortality and late survival for older veterans who underwent above- or below-knee amputations in 119 Veterans Affairs (VA) hospitals from 1991 1995. Methods. Preoperative medical conditions laboratory values abstracted by the VA National Surgical Quality Improvement Program were linked subsequent hospitalization through 1999. Logistic regression proportional hazards models develop indexes long-term survival. Results. Thirty-day was 6.3% 1909 13.3% 2152 above-knee amputees. Mortality varied greatly between lowest-highest index quartiles (0.8%-18.4% amputation 2.3%-31.1% amputation). Surviving patients had 10,827 hospitalizations during a median 32-month follow-up. Survival probabilities below- amputees 77% 59% at 1 year, 57% 39% 3 years, 28% 20% 7.5 years. The lowest quartile of 61% five-year compared with 14% highest-risk quartile. Conclusion. generic can be use stratifying prognosis after major amputation. heavy burden hospital these suggests need better disease management this high-risk, high-cost patient population. (Surgery 2001;130:21-9.)