Amputations in a tertiary care hospital

Othman Maimani, Zohair Jamil Gazzaz, Mian Usman Farooq

Abstract


Objective. This study was conducted to highlight the patternof amputations and their outcome in a tertiary care hospitalover a period of 16 months. Material and Methods. This retrospectivestudy of medical records was conducted at the Al-Noor Specialist Hospital, Makkah, Saudi Arabia from 04-03-2004 to 18-06-2005. The subjects’ files were extracted by usingICD-10 codes for amputations from the medical recordsdepartment by the authors of the Health Research Center.The files were reviewed for surgeons’ clinical notes as well asnurses’ notes. Operating theatre notes were also reviewed indetail. Certain variables were documented, including demography,clinical aspects and outcomes of amputations. Results.Of 50 study subjects males accounted for 72% and 84% wereSaudis. Fifty percent were middle aged (range 45-64yrs). Therange of stay was 3-48 days and 44% patients stayed for 3-7days. There were 43 (86%) amputations due to diabetes withperipheral circulatory disorder. Forty two (84%) of patientsimproved and 12% were discharged against medical advice(DAMA) after amputation whereas 6% died. Forty-four percentof patients were admitted once, while 2% of patients werereadmitted 9 times. The most amputations were at the level ofthe toes (54%), followed by 17 around the knee (34%). Nineteen(38%) patients underwent amputation under generalanesthesia. The re-amputation rate was 10%. Conclusion.Diabetes with peripheral vascular disease and neuropathywas the main cause of amputations in our hospital.

Keywords


Amputation, Diabetic, Traumatic, Peripheral circulatory disorder.

Full Text:

PDF

References


Fiddian NT, Lettin A, Donell S. Amputations. In: Kirk RM, editors. General surgical operations. 3rd ed. New York: Churchchill Livingstone; 1994. p. 599-612.

Gamba MA, Gotlieb SLD, Bergamaschi DP, Vianna LAC. Lower extremity amputations in diabetic patients: a case – control study. Rev Saude Publica. 2004;38(3):399-404.

Krupski WC. Overview of Extremity Amputations. In: Rutherford RB, editors. Vascular Surgery. 5th ed. USA: W.B. Saunders; 2000.vol: 2. p. 2175-2199.

International Statistical Classification of Diseases and Related Health Problem. 10th Version, Vol. 2. Geneva: WHO; 1992.

Al-Turaiki HS, Al- Falahi LA. Amputee population in the Kingdom of Saudi Arabia. Prosthet Orthot Int. 1993;17(3):147-56.

Trautner C, Haastert B, Spraul M, Giani G, Berger M. Unchanged Incidence of Lower-Limb amputations in a German City, 1990-1998. Diacare-Trautner et al. [serial online] 2001; 24(5):855. File://:A:Dia Care--Trautner et al_24(5) 855.htm.

Dangelser G, Besson S, Gatina J, Blickle I. Amputations among diabetes in Reunion Island. Diabetes Metab. 2003;29(6):628-34.

B. Agarwal AK, Goel MK, Srivastava RK, Rastogi S. A clinical study of amputations of lower limb. Prosthet Orthot Int. 1980;4(3):162-4.

Leung HB, Wong WC, Wu FC, Guerin JS. Preoperative and rehabilitation outcome after lowerlimb amputation in elderly Chinese patients in Hong Kong. J Orthop Surg. 2004;12(1):102-9.

Mohamed IA, Ahmed AR, Ahmed ME. Amputation and prostheses in Khartoom. J R Coll Surg Edinb. 1997;42(4):248-51.

Johannesson A, Larsson GU, Oberg T. From major amputation to prosthetic outcome: a prospective study of 190 patients in a defined population. Prosthet Orthot Int. 2004;28(1):9-21.

Schwartz SI. Amputations. In: Schwartz SI, Shires GT, Spencer FC, Hussar WC. Principles of Surgery. 6th ed. USA: McGraw Hill; 1994, volume 2, 1967-1984.

Laaperi T, Pohjolainen T, Alaranta H, Karkkainen M, Lower limb amputations. Ann Chir Gynaecol. 1993;82(3):183-7.

Stinus H, Shuling S, Geerken J. Epidemiologal data on lower limb amputations. A study of 1487 amputations. Z Orthop Ihre Grenzgeb. 1994 May-June;132(3):239-43.[English translation]

Eskelinen E, Eskelinen A, Hyytinen T, Jaakola A. Changing patterns of major lower limb amputations in Sienajoki Central Hospital 1997-2000. Ann Chir Gyaecol. 2001;90(4):290-3.

Hussein WI, Diabetes and foot care: World Diabetes Day. Middle East Med---online edition. [serial online] 2005 Nov; 3(11):[1 screen]. Available from: www.middleeastmedical.com/Articles.asp?Article=1256 - 31k. Accessed November 2005.

Nazim A. Incidence of lower extremity amputations in diabetics. Pol Arch Med Wewn. 2001;106(3):829-38.

Tentolouris N, AL-Sabbagh S, Walker MG, Boulton AJ, Jube EB. Mortality in diabetic and non-diabetic patients after amputations performed from 1990 to 1995: a five year follow up study. Diabetes Care. 2004;27(7):1598-604.

Ebskov LB. Trauma-related major lower limb amputations: an epidemiologic study. J Trauma. 1994;36(6):778-83.

Jacot E, Scheidegger K, Mahler F. The diabetic Foot. Schweiz Rundsh Med Prax. 1999;79(41):1213-6.

Birke JA, Patout CA Jr, Foto JG. Factors associated with ulceration and amputation in the neuropathic foot. J Orthop Sports Phys Ther. 2000;30:91-7.


Refbacks

  • There are currently no refbacks.


2016 Department of Medical Sciences, Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina. All rights reserved.
 
The full text of articles published in this journal can be used free of charge for personal and educational purposes while respecting authors and publishers’ copyrights. For commercial purposes no part of this journal may be reproduced without the written permission of the publisher.