685. Identifying the Incidence and Risk Factors for Reamputation among Patients who Underwent Foot Amputation
Session: Poster Abstract Session: Skin, Soft Tissue and Joint Infections
Friday, October 21, 2011
Room: Poster Hall B1
Handouts
  • Yuriko Kono, IDSA poster.pdf (258.3 kB)
  • Background:  

    Many patients who have lower-extremity amputations secondary to peripheral vascular disease or diabetes require reamputation eventually. This study was designed to identify the incidence of and risk factors for ipsilateral reamputation after forefoot amputation, to evaluate if postoperative infection increases the risk of reamputation, and to evaluate if the risk of reamputation was reduced by the duration of antimicrobial therapy after amputation.

    Methods: 

    A retrospective analysis of the patients who underwent foot amputation for non- traumatic reason from January 2002 to December 2004 at VA Pittsburgh Healthcare System was performed.

    Results: 

    Among 116 patients, 57 patients (49.1%) had ipsilateral reamputation within 3 years after their first surgeries. 78.9% received reamputation in the first 6 months. 53 patients (45.7%) died within 3 years. 16 patients (13.8%) developed postoperative infections. Upper level of amputation, long duration of hospitalization, insulin dependent diabetes and gangrene on physical exam on admission were risk factors for reamputation in univariable analysis. Gangrene (OR 3.81, 95% CI: 1.60-9.12, p=0.003) and insulin dependent diabetes (OR 2.93, 95% CI: 1.26-6.78, p=0.012) were risk factors in multivariable analysis. Postoperative infection did not increase the risk of reamputation. Longer than two week course of antibiotic use after amputation did not prevent reamputation. 

    Conclusion:

    About half of patients required ipsilateral reamputation and died in 3 years. Gangrene on admission and history of insulin dependent diabetes were significant risk factors (p=0.003, p=0.012). Long duration of antibiotic use after amputation and postoperative infection did not change the risk of reamputation.


    Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

    Yuriko Kono, MD, Medicine, University of Pittsburgh, Pittsburgh, PA and Robert Muder, MD, VA Pittsburgh Healthcare System, University of Pittsburgh School of Medicine, Pittsburgh, PA

    Disclosures:

    Y. Kono, None

    R. Muder, None

    Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.