J Vasc Nurs. 2025 Dec;43(4):210-215. doi: 10.1016/j.jvn.2025.08.005. Epub 2025 Aug 31.
ABSTRACT
PURPOSE: To describe individual characteristics of those admitted in 2023 to the academic vascular surgery unit with chronic limb-threatening ischemia (CLTI) who underwent a major lower limb amputation.
METHODS: A descriptive, cross-sectional retrospective chart review was conducted of major limb amputations (BKA, AKA) performed in 2023 by vascular surgery at a major academic medical center in the Southeastern United States. Variables extracted included age, sex, and comorbid conditions. Descriptive statistics (frequencies, percentages, and means) were used to describe the sample.
RESULTS: There were 48 patients. Thirty-three were males. The mean age was 65. Thirty-seven individuals had a prior history of smoking. Other comorbidities included Coronary Artery Disease (CAD) (n = 31), Diabetes Mellitus (n = 31), Hyperlipidemia (n = 36), and Hypertension (n = 39). Those with CAD tended to have longer hospitalizations than those without CAD. The length of stay for those without CAD ranged from 4 to 19 days (median=12), while those with CAD the length of stay ranged from 3 to 65 days (median=15). Twenty-one of the 48 had a prior amputation (TMA, BKA, AKA). Forty-two patients were discharged from the hospital. The discharge destinations varied significantly with one of the patient characteristics: female sex (p = 0.005) None of the women were discharged home, while 27.6 % of the men went home. Thirty-two patients were referred to the prosthetics and orthotics department with 29 patients being fitted for a prosthetic limb. Twenty-three of the 29 (79.3 %) who underwent a BKA were fitted for a prosthesis, while 6 of the 19 (31.6 %) who underwent an AKA were fitted for a prosthesis.
CONCLUSION: Forty-eight patients had major lower extremity amputations on the vascular surgery unit. When the characteristics were compared between BKAs and AKAs only age was close to significance (p = 0.081), with AKAs occurring in older individuals on average, compared with BKAs. There was also evidence (p = 0.053) that the severity of the amputation was related to discharge destination, with those with an AKA discharged more often to a skilled nursing facility and less often to rehabilitation than those with a BKA. Many factors affect the ability to walk with a prosthesis such as the severity of amputation, co-morbid conditions and living situation. Multidisciplinary teams are critical to ensure improved outcomes especially for the older amputee undergoing major limb amputation.
PMID:41390219 | DOI:10.1016/j.jvn.2025.08.005