Results of lower extremity amputations in patients with end-stage renal disease

Christos D. Dossa, Alexander D. Shepard, Aaron M. Amos, Warren L. Kupin, Daniel J. Reddy, Joseph P. Elliott, Judith M. Wilczewski, Calvin B. Ernst

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66 Scopus citations

Abstract

Purpose: The purpose of this study was to determine the impact of end-stage renal disease (ESRD) on the outcome of patients undergoing lower extremity (LE) amputation. Methods: Hospital charts and vascular surgery registry data were reviewed for all patients who underwent LE amputation over a consecutive 56-month period. The results of 84 patients with ESRD (137 amputations) were compared with 375 patients (442 amputations) without ESRD. Results: Hospital mortality rate was significantly greater in patients with ESRD than patients without ESRD, 24% versus 7% (p = 0.001). Patients with ESRD undergoing minor amputations had mortality rates three times greater than patients without ESRD undergoing major LE amputations. In patients with ESRD requiring bilateral or unilateral above-knee amputation hospital mortality rates were 43% and 38%, respectively. In addition, patients with ESRD were seven times more likely to undergo bilateral amputation than patients without ESRD over a mean follow-up period of 17 months. No kidney transplant patients died after amputation. Conclusion: ESRD has a profound negative impact on morbidity, mortality, and survival rates after LE amputation. Attempts at prevention of amputation with aggressive foot care and patient education in this high-risk group should be the focus of therapy.

Original languageEnglish (US)
Pages (from-to)14-19
Number of pages6
JournalJournal of vascular surgery
Volume20
Issue number1
DOIs
StatePublished - Jul 1994
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

Cite this

Dossa, C. D., Shepard, A. D., Amos, A. M., Kupin, W. L., Reddy, D. J., Elliott, J. P., Wilczewski, J. M., & Ernst, C. B. (1994). Results of lower extremity amputations in patients with end-stage renal disease. Journal of vascular surgery, 20(1), 14-19. https://doi.org/10.1016/0741-5214(94)90170-8