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. 2022 Nov 12:84:104864.
doi: 10.1016/j.amsu.2022.104864. eCollection 2022 Dec.

The effect of amputation level on patient mental and psychological health, prospective observational cohort study

A Abdel Rahim  1 , A Tam  1 , M Holmes  1 , D Mittapalli  1
Affiliations

The effect of amputation level on patient mental and psychological health, prospective observational cohort study

A Abdel Rahim et al. Ann Med Surg (Lond). .

Abstract

Background: Non-traumatic lower limb amputation is a commonly performed surgical procedure and is associated with a high prevalence of psychological morbidity including anxiety and depression. Many risk factors have been identified, including the indication for amputation, perioperative pain and sociodemographic factors.

Objective: The aim of this study was to identify whether level of amputation has an impact on this psychological morbidity.

Methods: A prospective observational study was conducted in a tertiary vascular unit including all adult non-traumatic amputations performed during a 6 month period. The Hospital Anxiety and Depression Scale (HADS) was used to score anxiety and depression pre and postoperatively.

Results: 49 patients met the inclusion criteria (22 trans-femoral amputations (AKA) and 27 trans-tibial amputations (BKA)). HADS scores for anxiety and depression were high in both groups both pre and postoperatively. A higher level of anxiety was noted in the BKA group, significantly decreasing postoperatively (p < 0.05). No other statistically significant differences were found between the two groups.

Conclusion: In non-traumatic amputations, there appears to be a higher rate of pre-operative anxiety in patients undergoing trans-tibial amputation compared with trans-femoral amputees. However, the level of amputation does not appear to have a significant effect on psychological status of patients with high rates of depression and anxiety demonstrated in both groups.

Keywords: Hospital anxiety and depression score for anxiety (HADS-A); Hospital anxiety and depression score for depression (HADS-D); Mental and psychological health; Non-traumatic amputations; Tans-femoral amputation; Trans-tibial amputations.

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Conflict of interest statement

No conflicts of interest.

Figures

Fig. 1
Fig. 1
HADS scoring questionnaire.
Fig. 2
Fig. 2
Comparison of the pre-operative and post-operative HADS-A in both groups.
Fig. 3
Fig. 3
Comparison of the pre-operative and post-operative HADS-D in both groups.
See this image and copyright information in PMC

References

    1. Cansever A., Uzun O., Yildiz C., Ates A., Atesalp A.S. Depression in men with traumatic lower part amputation: a comparison to men with surgical lower part amputation. Mil. Med. 2003 Feb;168(2):106–109. - PubMed
    1. Stern Anna F. The hospital anxiety and depression scale. Occup. Med. July 2014;64(Issue 5):393–394. - PubMed
    1. Baby S., Chaudhury S., Walia T.S. Evaluation of treatment of psychiatric morbidity among limb amputees. Ind. Psychiatr. J. 2018 Jul-Dec;27(2):240–248. - PMC - PubMed
    1. Krzemińska S., Kostka A. Influence of pain on the quality of life and disease acceptance in patients with complicated diabetic foot syndrome. Diabetes, Metab. Syndrome Obes. 2021 Mar 19;14:1295–1303. - PMC - PubMed
    1. Yilmaz M., Gulabi D., Kaya I., Bayram E., Cecen G.S. The effect of amputation level and age on outcome: an analysis of 135 amputees. Eur. J. Orthop. Surg. Traumatol. 2016 Jan;26(1):107–112. - PubMed