Predictors of Mortality and Functional Outcomes Following Major Lower Limb Amputation: A Retrospective Study
DOI:
https://doi.org/10.64149/J.Ver.8.18s.174-179Keywords:
Major lower extremity amputations, Above-knee amputation, Below-knee amputation, Morbidities, Mortality, ComplicationsAbstract
Background: Major lower-extremity amputations (MLEAs) impose considerable clinical and socioeconomic burden, with the amputation level markedly affecting postoperative recovery.
Objective: This study compares the outcomes of above- (AKA) and below- (BKA) knee amputations, while identifying key risk factors for postoperative morbidity and mortality at King Faisal Specialist Hospital and Research Center in Jeddah, Saudi Arabia.
Methods: This retrospective study included 138 adult patients of both sexes (aged ≥18 years) who underwent MLEAs. The population was divided into two equal groups based on the level of amputation: AKA and BKA groups.
Results: The mean age was significantly greater in patients with AKA compared to those with BKA (p=0.007). Atrial fibrillation was more frequent in AKA cases (p=0.003). The lesion site differed significantly between groups (p<0.001), with leg lesions more common in AKA and foot lesions more frequent in BKA. Complications occurred more often in AKA than BKA (p=0.051), with infection being the most frequent in both groups. Mobility outcomes differed significantly (p=0.013), as most AKA patients were immobile, while some BKA patients achieved limited or independent walking. Mortality was higher in AKA (21.54%) than BKA (13.85%) without a significant difference (p=0.250). Age, sex, and comorbidities were not significantly associated with mortality.
Conclusions: In this Saudi cohort, AKA was associated with higher clinical risk and poorer functional outcomes compared with BKA. Patients undergoing AKA were generally older and presented with more advanced disease, while BKA patients demonstrated comparatively better postoperative mobility potential.
