DOS 2019

DOS Kongressen 2019 · 169 Non-traumatic Lower Extremity Amputation (LEA) in a historic cohort –can we improve quality of life? Ines Willerslev Jørgensen, Dorte Dall-Hansen, Hanne Popp, Carsten Jensen Orthopaedic Surgery and Traumatology, Kolding Hospital Background: The need to perform amputations has existed since ancient times, but the indication for surgery has changed drastically since World War II. E.g. amputations, due to trauma, have been reduced, while amputations, due to vas- cular disease and diabetes, have become more frequent. However, there is little knowledge on this group of patients and their in-hospital treatment and physi- cal challenges. Purpose / Aim of Study: To describe the group of non-traumatic patients undergoing above-knee- amputation (AKA), below-knee- amputation (BKA) and re-amputation (REA). Describe current in-hospital treatment, mortality and readmissions. Materials and Methods: A retrospective cohort study, the medical records of 142 patients undergoing non-traumatic lower extremity amputation, at Kolding Hospital, Denmark, from March 2015 to December 2016, were included and data from their medical records were extracted using a standardized question- naire. Findings / Results: The mean age was 72 (12) years and 64% of the pa- tients were men. Of the 142 patients, 90% had vascular disease and 50% had diabetes. 70% of the patients were ASA 3. 72% was admitted from the out- patient clinic or the vascular surgery department. 35% had medical audits dur- ing their hospitalization. 46% was mobilized to chair within 24hours and 83% during hospitalization. Infection was the most common complication (45%). AKA-patients had higher mortality at 30-days (18%) and 1-year (38%) while 8% and 15% for BKA-patients . 31% of AKA-patients were categorized ASA 4 compared with BKA (11%) and REA (21%). There was no difference in 30 days and 1-year readmission rate (13% and 35 %). Conclusions: Lower extremity amputees deal with severe comorbidities and are in high risk of complications, readmissions and death. The current treatment focus on a multidisciplinary approach, however, does not include doctors of in- ternal medicine. We discuss if the indication for amputation should be viewed as either a life-saving or palliative treatment. The patient’s risks and non-surgical alternatives should be considered. We also point out the need for a scoring sys- tem for mobilization that focuses on essential activities. 125.