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. 2024 Nov 18;16(11):e73947.
doi: 10.7759/cureus.73947. eCollection 2024 Nov.

Impact of Timing of Minor Amputations After Revascularization on Patient Outcomes

Rema AlRashed  1 , Faisal A Albogomi  2 , Faisal A Almudaiheem  1 , Talal A Almutairi  1 , Khalid A Albassam  1 , Fahad K Aljaber  2 , Hussam A Alharbi  3
Affiliations

Impact of Timing of Minor Amputations After Revascularization on Patient Outcomes

Rema AlRashed et al. Cureus. .

Abstract

Background: Vascular complications from diabetes contribute significantly to major and minor limb amputations. Diabetes is a major health burden in Saudi Arabia, with increased incidence in rural areas. The purpose of this study was to evaluate the timing of minor lower limb amputations after revascularization and their relative outcomes.

Methods: This was a retrospective study done in Prince Sultan Military Medical City, Riyadh, Saudi Arabia. Patients who underwent minor lower limb amputation after revascularization during 2018-2022 were included in the study.

Results: Of the 90 patients who were eligible for the study, 83 (94%) were diabetic, and 66 (73%) underwent revascularization. The timing between revascularization and amputation varied, with 34 (37.8%) amputations occurring on the same day as revascularization, 17 (18.9%) occurring within seven days of revascularization, and 39 (43.3%) occurring more than seven days post-revascularization. No significant differences in amputation (p=0.105) were observed based on the timing of amputation after revascularization. Diabetic patients showed significantly higher rates of wound infection (p=0.028) and longer healing times (p=0.000). Finally, diabetic patients were more likely to have healing times of more than 60 days (25.9%) compared to non-diabetic patients (20.0%).

Conclusion: Based on our results, the timing of endovascular or surgical repair did not affect patient outcomes. Moreover, diabetes was found to be a prognostic factor for poor wound healing and infection.

Keywords: amputation; cli; diabetic foot; endovascular; open repair.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Prince Sultan Military Medical City Scientific Research Center issued approval E-2148. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Time between revascularization and amputation.
Figure 2
Figure 2. Stratification of outcomes based on time between amputation and revascularization.
Figure 3
Figure 3. Length of hospital stay according to time between revascularization and amputation.
Figure 4
Figure 4. Comparison of time between revascularization and amputation between diabetic and non-diabetic groups.
See this image and copyright information in PMC

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