மருத்துவ ஆராய்ச்சி இதழ்

Outcomes of Major Lower Limb Amputation among Patients at a Refferal Hospital

Abstract

Francis Basimbe, Dionizi Muganga and Fredrick Mutyaba

Background: Patients undergoing major lower limb amputation sometimes have complicating underlying comorbidities that are likely to have significant influence on post-operative morbidity and mortality and long-term psychological status. This necessitates the healthcare system to plan for the amputees’ needs to achieve best outcomes.

So we aimed to determine the outcomes of major lower limb amputation among patients at our Hospital.

Methods: A retrospective cross-sectional study was conducted using medical records of 75 patients who underwent major lower limb amputation between 1st January 2016 and 31st December 2020 at St. Francis Hospital Nsambya. Variables including socio-demographic characteristics (age, sex), clinical factors (mean arterial pressure, random blood sugar, glycated hemoglobin), causes of amputation (trauma, neoplasms, diabetes mellitus, peripheral arterial disease, infections, congenital anomalies) and short-term outcomes (re-amputation, length of hospital stay, in-hospital mortality) were collected from patients' files. Intermediate outcomes (utilization of physiotherapy services) and long-term outcomes (prosthetic use, functional return and psychological status) were collected through phone calls.

Results: only 2(3%) underwent re-amputation. In-hospital mortality was 10.7% with deaths registered only among those aged ≥ 50 years. Average length of hospital stay was 12.8 ± 8.4 days. Physiotherapy utilization was 85.3% and it increased with older age (p=0.002). 16(26.2%) utilized prosthetics with majority being males. Majority (62.3%) of amputees had been able to return to work; 73.8% were still married. Psychological status score ranged from 4 to 10 with mean of 7.5 ± 1.7.

Conclusion: Majority of patients had gained full functionality with good utilization of physiotherapy services which are very key in improving amputees’ quality of life, thus the high psychological status scores. However, we found a low prosthetic uptake among our patients.