Patterns, Indications and Outcomes of Major Limb Amputations at Tikur Anbesa Hospital, Ethiopia: A Retrospective Cohort Study (2019-2024).
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Date
2024-09-10
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Addis Ababa University
Abstract
Introduction: Amputation is a critical surgical procedure with a history dating back to ancient times. Despite advancements in surgical techniques and rehabilitation, limb amputations remain necessary for various medical conditions, including irreversible ischemia, severe trauma, uncontrollable infections, and malignancies. Globally, the causes and outcomes of amputations vary significantly, with peripheral vascular disease being the leading cause in developed countries, while trauma and infections predominate in developing nations. Ethiopia, like many low- and middle-income countries (LMICs), faces unique challenges in managing patients
requiring amputations, influenced by local health infrastructure, cultural practices, and disease prevalence.
Methods: An institution-based retrospective cohort study was conducted at Tikur Anbesa Hospital, Ethiopia, analyzing medical records of patients who underwent major limb amputations between 2019 and 2024. Data were collected using a pre-tested, coded questionnaire and analyzed using SPSS version 25 computer software.
Results: A total of 190 patients were included in the study. The age range from 8 to 90 years (mean age 43.5 yrs) and male to female ratio is 2.8 to 1. Above knee amputation is the most common pattern with 53.7%. Peripheral arterial disease is the leading cause of major limb amputation with 43.5% followed by trauma (28.9%) and tumor (21.6%). Two third of those with peripheral arterial disease has diabetes mellitus. The post operative complication rate was 40% and surgical site infection was the commonest (36.3%). Statistical significant association was found between post operative complication and those who are operated for an indication of trauma and sever infection. The intra hospital mortality rate was 6.3% and only 34% patients were fitted with prosthesis.
Conclusion- Peripheral arterial disease, trauma and tumor are the commonest indication of major limb amputation in our setting. Majority of amputation are preventable by providing health education, early presentation and proper management of the commonest cause of amputation.
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Limb Amputation, Surgical Outcomes, Peripheral Vascular Disease, Trauma, Tikur Anbesa Hospital, Addis Ababa, Ethiopia