| 000 | 03556nam a22003977a 4500 | ||
|---|---|---|---|
| 008 | 240424s20242024 xxu||||| |||| 00| 0 eng d | ||
| 022 | _a0890-5096 | ||
| 024 | _aS0890-5096(24)00051-7 [pii] | ||
| 040 | _aOvid MEDLINE(R) | ||
| 099 | _a38387800 | ||
| 245 | _aRisk Factors for Lower Extremity Minor Amputation Conversion to Major Amputation. | ||
| 251 | _aAnnals of Vascular Surgery. 104:166-173, 2024 Feb 20. | ||
| 252 | _aAnn Vasc Surg. 104:166-173, 2024 Feb 20. | ||
| 253 | _aAnnals of vascular surgery | ||
| 260 | _c2024 | ||
| 260 | _fFY2024 | ||
| 260 | _p2024 Feb 20 | ||
| 265 | _saheadofprint | ||
| 265 | _tPublisher | ||
| 266 | _d2024-04-24 | ||
| 501 | _aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007 | ||
| 520 | _aBACKGROUND: Minor lower extremity amputations (LEAs) have become an important part of the limb salvage approach but are not as benign as previously thought. This study investigates the difference in outcome between toe/ray versus midfoot amputations and the risk factors for major amputation conversion associated with each procedure. | ||
| 520 | _aCONCLUSIONS: While there is a consistency with previous studies that found no significant overall difference in mortality between types of minor LEA, we have extended this previous work by demonstrating the independent risk factors for conversion to major amputation between types of minor LEA. Comparing these 2 groups will assist surgeons in choosing the appropriate level of amputations and will enhance patient's understanding of their chance of wound healing and risk of repeat amputation. Copyright © 2024 Elsevier Inc. All rights reserved. | ||
| 520 | _aMETHODS: We performed retrospective chart review of foot amputation patients at a single tertiary care medical center with a primary end point of conversion to major amputation and secondary end points of 1-year wound healing and mortality rate. We collected data on relevant medical comorbidities, noninvasive vascular imaging, revascularization, repeat amputations, wound healing rate, and 1-year mortality. Patients were separated into toe/ray amputations versus midfoot amputation groups and compared using descriptive statistics, Chi-squared tests, Cox proportional hazards, and a multivariate logistic regression model. | ||
| 520 | _aRESULTS: A total of 375 amputations were included in the analysis. 65.3% (245 patients) included toe/ray amputations and 34.7% (130 patients) included midfoot amputations. We compared these 2 cohorts with regard to their rate of conversion to repeat minor and/or major amputation in addition to overall mortality. The toe/ray group underwent more repeat minor amputations within 1 year after index amputation (34.7% vs. 21.5%, P = 0.008) and wound healing (epithelization) at 90 days was also higher in this group. The midfoot group had a higher conversion to major LEA within 1 year on univariate analysis (20.8 vs. 6.9%, P < 0.001). Overall 1-year mortality was 6.17% and there was no significant difference between groups. | ||
| 546 | _aEnglish | ||
| 650 | _aIN PROCESS -- NOT YET INDEXED | ||
| 650 | _zAutomated | ||
| 651 | _aMedStar Franklin Square Medical Center | ||
| 656 | _aGeneral Surgery Residency | ||
| 657 | _aJournal Article | ||
| 700 |
_aKawaji, Qingwen _bMFSMC _cGeneral Surgery Residency _dMD |
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| 790 | _aRolle NP, Kawaji Q, Morton C, Rosenberg KM, Kalsi R, Blitzer DN, Nagarsheth K | ||
| 856 | _uhttps://dx.doi.org/10.1016/j.avsg.2023.12.066 | ||
| 942 |
_cART _dArticle |
||
| 999 |
_c14083 _d14083 |
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