Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellin, Colombia

Introduction: Major amputation is a significant intervention in advanced stages of peripheral arterial disease (PAD) and has important morbidity and mortality rates. Despite being a frequently performed procedure in Colom-bia, local statistics on its frequency and outcomes are not available. Objectives: To analyze the morbidity and mortality in patients with lower limb PAD during the 30 days following major amputation or during the in-dex hospitalization. To identify factors related to the outcome and charac-terize the population. Methods: A retrospective study of patients with lower limb PAD who un-derwent major amputation for acute ischemia (AI) or chronic limb -threate-ning ischemia (CLTI) between March 2011 and December 2019 at Hospital Universitario San Vicente Fundacion in Medellin, Colombia (HUSVF). Varia-bles related to the underlying disease and perioperative morbidity were calculated in a general analysis and by groups, according to the level of amputation. Results: A total of 558 major amputations were performed, 83.5% for CLTI. The overall mortality rate was 14.7%, with 32.6% in AI and 11.2% in CLTI. The most frequent complication was delirium (28.8%). After multivariate analysis, no influential factors were identified for fatal outcomes, except for cardiovascular complications in AI. Conclusions: In this study, the only variable related to early mortality was cardiovascular complications in patients with AI. The percentages of heart disease are lower compared to those reported in studies from other coun-tries. The most common complication was delirium.