Amputation in Kingdom of Saudi Arabia: Etiology, Characteristics and Clinical status from a Large Tertiary Rehabilitation Center

Abstract

AbstractIntroductionLimb amputation significantly impacts the patient’s physical, emotional, and social life. Multiple etiological factors may lead to limb amputation. Unfortunately, there is limited data about amputation in Saudi Arabia. Since Sultan Bin Abdulaziz Humanitarian City (SBAHC) is a tertiary centre receiving such patients, we collected data from ten years to look at the etiology, characteristics, and clinical impact of amputations in the Kingdom.MethodsA retrospective study of 1409 amputee patients’ data at SBAHC collected over ten years included demographic variables, etiology, site, level, and type of amputation. We also collected Functional independent measurement (FIM) scores for 618 patients.ResultMales constitute the majority of amputees (75.7%) and the average age in males was higher in males compared to females (45 vs 36 years respectively, p<0.001). Vascular diseases (42.3%) and Trauma (36.8%) were the leading cause of amputation in this cohort. Diabetes mellitus was the most frequent comorbidity (40.5%), followed by hypertension (26.2%). Transtibial amputations were the most typical (22.58%), followed by trans-femoral amputation (14.12%). Traumatic trans-femoral amputation was more prevalent among young adults than traumatic trans-tibial amputation. Trauma-related amputation cases were highest in the age group of 21-30 years (69.2%), while vascular related amputations were highest in the age group of 70 and above years (89.5%). FIM scores improved significantly in locomotion (33.6%) followed by transfer (30.6%) and self-care (16.4%) at six-month post discharge compared to admission (all p-values<0.01).ConclusionVascular pathology arising due to chronic diseases is the primary risk factor that may lead to amputation and warrant primary and secondary prevention programs. Seatbelt enforcement can significantly decrease amputation related to Road Traffic Accidents, which has been the second most familiar cause of amputation.