Indications and short term outcomes of major limb amputations at the university teaching hospitals adult and emergency hospital, Lusaka, Zambia.
Date
2020
Authors
Nakazwe, Mildred
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
Introduction: Limb amputation is the surgical removal of all or part of a limb or extremity
such as an arm, leg, foot, hand, toes or fingers. A major limb amputation is performed
proximal to the wrist or ankle. There are various indications and short term outcomes for
major limb amputations. Limb amputations can lead to poor outcomes such as morbidity,
high cost on the patients and their families and an increase in the Disability Adjusted Life
Years (DALY’s) and mortality. Therefore this study was aimed at assessing the
indications and short term outcomes of major limb amputations at UTH-Adult hospital,
Lusaka, Zambia.
Methodology: This was a cross-sectional study with a 30 days follow-up after amputation
was done. A data collection tool was administered after the amputation was done to collect
demographics, indications that led to the amputation, information on the operation as well
as any complications that occurred. The patient was followed up on day 1, 7, 14 and 30
while in the hospital and the outpatient clinic. The data collected was analysed using
STATA version 13.
Results: A total of 80 patients recruited into the study and 43(53.8%) were males and
37(46.3%) were females. The mean age of the patients was 52.2(SD, 17). The most
common indication was found to be diabetic foot 36 (45%). Only 9(11.3%) were
amputated due to trauma. Out of the 80 patients, 54(67.5%) developed a complication, 48
(88.9%) had local complications and 11(20.4%) had systemic complications. The most
common complication was surgical site infection alone 24 (44.4%), followed by those that
had multiple 13 (24.1%) then phantom limb pain (16.7%). Renal complications accounted
for 6(11.1%) of those that developed a complication. The 30-day mortality rate was 18.8%
with sepsis being the most common cause of death, followed by septic shock and acute
kidney injury.
Conclusion: The main indication for major limb amputations at UTH was diabetic foot
and trauma was amongst the least. The most common postoperative complication was
surgical site infection. The 30-day mortality rate was 18.8% with sepsis being the main
cause of death.
Recommendation: Formation of diabetic foot clinics in the primary health centres to
diagnose and treat complications of diabetes that may lead to limb amputation.
Keywords: Indications, short term outcomes, limb, amputations, University Teaching
Hospital, Zambia
Description
Thesis
Keywords
Amputation--adverse effects. , Amputation--methods. , Amputations.