Comparison of end-of-survival below-knee and above-knee amputations with demographic, comorbidity and hematological parameters

Abstract

Abstract Introduction: In this study, it was aimed to establish mortality predictive parameters with a higher contribution to mortality by comparing the demographic data, comorbid factors and hematological values of patients who underwent below-knee and above-knee amputation at the end of survival. Materials and Methods: Eighty-seven patients who were amputated with the diagnosis of diabetic foot between March 2014 and January 2022 and resulted in mortality due to natural causes during follow-up were included in the study. Those who were amputated below the knee were named Group 1 (50 patients), and those who were amputated above the knee were named Group 2 (37 patients). The patients' age, gender, side, comorbid diseases, ASA score, anesthesia type, time to surgery, total hospital stay, CCI (Charlson comorbidity index), ex time and hematological values at the time of first admission were compared in both groups and statistical analysis was performed. Results: Group 1 and Group 2 had similar distribution in terms of age, gender, side of operation, number of comorbid diseases, time to surgery and CCI (p>0.05). Group 2's mean ASA score, rate of admission to general anesthesia, total hospital stay and crp level were statistically higher than Group 1 (p<0.05). Ex time, albumin value and HgA1c level were statistically lower in Group 2 compared to Group 1 (p<0.05). There was no significant difference in hemogram, wbc, % lymphocyte, % neutrophil, creatinine and Na values of both groups at the time of first application (p>0.05). Conclusions: It was seen that high ASA score, low albumin value and high crp value were significant predictors of high mortality. Creatinine level and HgA1c value were quite unsuccessful in predicting mortality. Levels of evidence: Level 3, Retrospective comparative study