Non-traumatic lower-limb amputations, primarily driven by diabetes and peripheral artery disease, remain a critical health concern with substantial mortality rates and a significant impact on patients’ quality of life. A comprehensive study conducted by the Medical University of Innsbruck spanning from 2006 to 2022 sheds light on the persistent challenges faced by individuals undergoing these procedures.
Rising Mortality and Comorbidity Trends
The analysis encompassed 1,107 patients who underwent lower-limb amputations for non-traumatic reasons. Findings indicate that both 30-day and 1-year mortality rates have remained alarmingly high, registering at 4.14%, 16.2%, and 23.2% respectively over the study period. Chronic kidney disease, heart failure, and major amputations emerged as significant predictors of 1-year mortality. Additionally, there has been a noticeable increase in comorbid conditions such as coronary heart disease, atrial fibrillation, and chronic pulmonary disease among these patients, highlighting the growing complexity of their medical profiles.
Sex-Based Differences in Outcomes
The study revealed distinct differences between male and female patients. Women tended to undergo amputations at an older age (78.9 years) compared to men (68.1 years). Moreover, median age increased and median LDL-cholesterol levels decreased in males over the years, trends not observed in females. Causes of death also varied by sex; females predominantly succumbed to diabetes, peripheral artery disease, and cerebrovascular disease, while males were more likely to die from liver disease, renal disease, and myocardial infarction. Notably, major amputations were more frequently the first surgical intervention in female patients than in their male counterparts.
Inferences
- Persistent high mortality rates suggest inadequacies in current post-amputation care strategies.
- The increasing prevalence of comorbidities complicates patient management and recovery.
- Sex-specific differences indicate the need for tailored medical approaches.
- Older age at amputation in women may reflect delayed intervention or differing disease progression.
The data underscores the urgent necessity for enhanced risk factor management in patients undergoing non-traumatic lower-limb amputations. This is particularly critical for female patients, who not only experience higher mortality rates but also face more severe comorbid conditions. Implementing targeted interventions and personalized treatment plans could potentially improve survival rates and quality of life for these individuals.
Addressing the high mortality and morbidity associated with non-traumatic lower-limb amputations requires a multifaceted approach. Healthcare providers must prioritize comprehensive management of underlying conditions such as diabetes and peripheral artery disease, and integrate multidisciplinary care teams to address the complex needs of amputees. Additionally, fostering patient education and proactive monitoring can aid in early detection and treatment of comorbidities, ultimately enhancing patient outcomes and reducing mortality rates.

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