Predictors of wound complications following major amputation for critical limb ischemia

摘要: Objectives For patients with end-stage critical limb ischemia (CLI) who have already suffered over an extended period of time, a major amputation that is free wound complications remains paramount. Utilizing data from the American College Surgeons, National Surgical Quality Improvement Program (ACS-NSQIP), objective this report was to determine factors leading following amputation. Methods ACS-NSQIP used identify ≥50 years, CLI, and having ipsilateral below-(BKA) or above-knee (AKA). The primary outcome occurrence (WO) defined by affirmative findings superficial infection, deep and/or disruption. secondary 30-day mortality. Following univariate analyses, multiple logistic regression performed predictive factors. Results Between January 1, 2005 December 31, 2008, 4250 fulfilled inclusion criteria (2309 BKAs 1941 AKAs). WOs were 10.4% for 7.2% AKAs. BKAs, increasing elevation in international normalized ratio (INR) predicted more ( P = .008, odds [OR] 1.5 every integral increase INR) as did age 50 59 compared older .002, OR 1.9). AKAs, being current smoker .0008, 1.8) body mass index (BMI) .02, 1.3 10 kg/m 2 BMI). Mortality 7.6% 12% Complete functional dependence most mortality AKA Conclusions Wound occurrences rates after CLI continue be prevalent problem. Normalization INR prior BKA should decrease WOs. Heightened awareness higher risk improved preventive measures, earlier disease recognition, better treatments, increased education remain improving outcomes stressed patient cohort.