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Predicting reamputation risk in patients undergoing lower extremity amputation due to the complications of peripheral artery disease and/or diabetes

British Journal of Surgery Jun 01, 2019

Czerniecki JM, et al. - Given a risk of treatment failure and the need for reamputation at a higher level among patients undergoing amputation of the lower extremity for the complications of peripheral artery disease and/or diabetes, researchers sought to develop a patient-specific reamputation risk prediction model. Using Veterans Health Administration databases, they identified nearly 5260 patients, of whom 1283 (24·4%) underwent ipsilateral reamputation in the 12 months after initial amputation.Patients with incident unilateral transmetatarsal, transtibial or transfemoral amputation had crude reamputation risks of 40·3%, 25·9%, and 9·7%, respectively. Eleven predictors (amputation level, sex, smoking, alcohol, rest pain, use of outpatient anticoagulants, diabetes, chronic obstructive pulmonary disease, white blood cell count, kidney failure and previous revascularization), along with four interaction terms were included in the final prediction model. As per findings, the developed prediction model may aid in clinical decision-making regarding amputation-level selection.
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