Predictors of re-amputation after major lower limb amputations in patients with peripheral arterial disease.

Introduction: amputation of the lower limb is an unwanted, but not the final outcome of treatment in patients with peripheral arterial disease. Unfortunately, a certain number of patients have local complications that indicate re-amputation, which significantly increases morbidity and mortality. Until some time ago, it was considered that a wrong assessment in planning the level of amputation was the only reason for re -amputation, but in practice it is shown that there are additional risk factors that can be marked as predictors of re-amputation. Aim: to determine risk factors that have a direct or indirect impact on the occurrence of local complications, which will ultimately result in re-amputation. Materials and methods: research was designed as prospective collection of variables, and subsequently, according to the model of a cohort study, a retrospective analysis of the data of patients hospitalized in the Clinical Center of the University of Sarajevo between January 2021 and December 2022 was performed. Results: the sample consisted of 165 patients who underwent below-the-knee or above-the-knee amputation. Out of that number, 65 (39.4%) patients were female and 100 (60.6%) were male patients. The average age was 70.92 (±10.95) years. The age range was 29-90 years. Re-amputation was performed in a total of 54 (32.7%) subjects, namely in 36 (32.4%) subjects who underwent below-the-knee amputations, and in 18 (33.3%) patients who underwent above-the-knee amputations. Conclusion: as predictors that carry the significantly highest risk of re-amputation are records of diabetes (p=0.012), hyperlipidemia (p=0.001), smoking addiction (p=0.001), and stump trauma (p=0.045). [ABSTRACT FROM AUTHOR]