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

Introduction: Major amputation serves as a significant intervention in advanced stages of peripheral arterial disease (PAD), exhibiting substantial morbidity and mortality rates. Despite its frequent utilization in Colombia, local statistics concerning its incidence and outcomes remain absent.Objectives: This study aims to analyze the morbidity and mortality in patients with lower limb PAD during the 30 days following major amputation or within the index hospitalization period. Additionally, it aims to ascertain outcome-related factors and characterize the patient population.Methods: A retrospective study was conducted on lower limb PAD patients undergoing major amputation due to acute limb ischemia (ALI) or chronic limb-threatening ischemia (CLTI) between March 2011 and December 2019 at Medellin's Hospital Universitario San Vicente Fundacion (HUSVF), Colombia. Variables related to baseline disease and perioperative morbidity were calculated both in a general analysis and segmented by amputation level.Results: A total of 558 major amputations were performed, with 83.5% attributed to CLTI. Overall mortality was 14.7%, comprising 32.6% for ALI and 11.2% for CLTI. The most prevalent complication was delirium (28.8%). Multivariate analysis demonstrated no influential factors in fatal outcomes, except for cardiovascular complications in ALI cases. Conclusions: This study underscores the sole association between cardiovascular complications and early mortality in ALI patients. Cardiac co -morbidity percentages are lower compared to findings in other countries. Delirium emerged as the most frequent complication.