Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, Colombia

ABSTRACT: Introduction: Major amputation is a significant intervention in advanced stages of peripheral arterial disease (PAD) and has important morbidity and mortality rates. Despite being a frequently performed procedure in Colombia, local statistics on its frequency and outcomes are not available...

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Autores:
Rosales Parra, Nicolas Dayam
Acero Murillo, Cristhian Fabian
Uribe Munera, José Andrés
Rosales Parra, Miguel Ángel
Timarán Rodríguez, René Fernando
Tipo de recurso:
Article of investigation
Fecha de publicación:
2023
Institución:
Universidad de Antioquia
Repositorio:
Repositorio UdeA
Idioma:
eng
OAI Identifier:
oai:bibliotecadigital.udea.edu.co:10495/39273
Acceso en línea:
https://hdl.handle.net/10495/39273
https://revistas.udea.edu.co/index.php/iatreia/article/view/348853
Palabra clave:
Amputation, Surgical
Amputación Quirúrgica
Colombia
Morbidity
Morbilidad
Mortality
Mortalidad
Peripheral Arterial Disease
Enfermedad Arterial Periférica
https://id.nlm.nih.gov/mesh/D000671
https://id.nlm.nih.gov/mesh/D003105
https://id.nlm.nih.gov/mesh/D009017
https://id.nlm.nih.gov/mesh/D009026
https://id.nlm.nih.gov/mesh/D058729
Rights
openAccess
License
https://creativecommons.org/licenses/by-nc-sa/4.0/
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oai_identifier_str oai:bibliotecadigital.udea.edu.co:10495/39273
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repository_id_str
dc.title.spa.fl_str_mv Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, Colombia
dc.title.translated.spa.fl_str_mv Desenlaces tempranos en amputación mayor de pacientes con enfermedad arterial periférica de miembros inferiores. Estudio en un hospital de referencia en Medellín, Colombia
title Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, Colombia
spellingShingle Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, Colombia
Amputation, Surgical
Amputación Quirúrgica
Colombia
Morbidity
Morbilidad
Mortality
Mortalidad
Peripheral Arterial Disease
Enfermedad Arterial Periférica
https://id.nlm.nih.gov/mesh/D000671
https://id.nlm.nih.gov/mesh/D003105
https://id.nlm.nih.gov/mesh/D009017
https://id.nlm.nih.gov/mesh/D009026
https://id.nlm.nih.gov/mesh/D058729
title_short Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, Colombia
title_full Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, Colombia
title_fullStr Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, Colombia
title_full_unstemmed Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, Colombia
title_sort Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, Colombia
dc.creator.fl_str_mv Rosales Parra, Nicolas Dayam
Acero Murillo, Cristhian Fabian
Uribe Munera, José Andrés
Rosales Parra, Miguel Ángel
Timarán Rodríguez, René Fernando
dc.contributor.author.none.fl_str_mv Rosales Parra, Nicolas Dayam
Acero Murillo, Cristhian Fabian
Uribe Munera, José Andrés
Rosales Parra, Miguel Ángel
Timarán Rodríguez, René Fernando
dc.subject.decs.none.fl_str_mv Amputation, Surgical
Amputación Quirúrgica
Colombia
Morbidity
Morbilidad
Mortality
Mortalidad
Peripheral Arterial Disease
Enfermedad Arterial Periférica
topic Amputation, Surgical
Amputación Quirúrgica
Colombia
Morbidity
Morbilidad
Mortality
Mortalidad
Peripheral Arterial Disease
Enfermedad Arterial Periférica
https://id.nlm.nih.gov/mesh/D000671
https://id.nlm.nih.gov/mesh/D003105
https://id.nlm.nih.gov/mesh/D009017
https://id.nlm.nih.gov/mesh/D009026
https://id.nlm.nih.gov/mesh/D058729
dc.subject.meshuri.none.fl_str_mv https://id.nlm.nih.gov/mesh/D000671
https://id.nlm.nih.gov/mesh/D003105
https://id.nlm.nih.gov/mesh/D009017
https://id.nlm.nih.gov/mesh/D009026
https://id.nlm.nih.gov/mesh/D058729
description ABSTRACT: Introduction: Major amputation is a significant intervention in advanced stages of peripheral arterial disease (PAD) and has important morbidity and mortality rates. Despite being a frequently performed procedure in Colombia, local statistics on its frequency and outcomes are not available. Objectives: To analyze the morbidity and mortality in patients with lower limb PAD during the 30 days following major amputation or during the index hospitalization. To identify factors related to the outcome and characterize the population. Methods: A retrospective study of patients with lower limb PAD who underwent major amputation for acute ischemia (AI) or chronic limb-threatening ischemia (CLTI) between March 2011 and December 2019 at Hospital Universitario San Vicente Fundación in Medellín, Colombia (HUSVF). Variables related to the underlying disease and perioperative morbidity were calculated in a general analysis and by groups, according to the level of amputation. Results: A total of 558 major amputations were performed, 83.5% for CLTI. The overall mortality rate was 14.7%, with 32.6% in AI and 11.2% in CLTI. The most frequent complication was delirium (28.8%). After multivariate analysis, no influential factors were identified for fatal outcomes, except for cardiovascular complications in AI. Conclusions: In this study, the only variable related to early mortality was cardiovascular complications in patients with AI. The percentages of heart disease are lower compared to those reported in studies from other countries. The most common complication was delirium.
publishDate 2023
dc.date.issued.none.fl_str_mv 2023
dc.date.accessioned.none.fl_str_mv 2024-05-13T22:30:11Z
dc.date.available.none.fl_str_mv 2024-05-13T22:30:11Z
dc.type.spa.fl_str_mv Artículo de investigación
dc.type.coar.spa.fl_str_mv http://purl.org/coar/resource_type/c_2df8fbb1
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dc.identifier.citation.spa.fl_str_mv Rosales-Parra ND, Uribe-Múnera JA, Timarán-Rodríguez RF, Acero-Murillo CF, Rosales-Parra MG. Early Outcomes in Major Amputation of Patients with Lower Limb Peripheral Arterial Disease: A Study in a Referral Hospital in Medellín, Colombia. Iatreia [Internet]. 2023 Oct-Dec;36(4):471-480. https://doi.org/10.17533/udea.iatreia.199
dc.identifier.issn.none.fl_str_mv 0121-0793
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/10495/39273
dc.identifier.doi.none.fl_str_mv 10.17533/udea.iatreia.199
dc.identifier.eissn.none.fl_str_mv 2011-7965
dc.identifier.url.spa.fl_str_mv https://revistas.udea.edu.co/index.php/iatreia/article/view/348853
identifier_str_mv Rosales-Parra ND, Uribe-Múnera JA, Timarán-Rodríguez RF, Acero-Murillo CF, Rosales-Parra MG. Early Outcomes in Major Amputation of Patients with Lower Limb Peripheral Arterial Disease: A Study in a Referral Hospital in Medellín, Colombia. Iatreia [Internet]. 2023 Oct-Dec;36(4):471-480. https://doi.org/10.17533/udea.iatreia.199
0121-0793
10.17533/udea.iatreia.199
2011-7965
url https://hdl.handle.net/10495/39273
https://revistas.udea.edu.co/index.php/iatreia/article/view/348853
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.ispartofjournalabbrev.spa.fl_str_mv Iatreia
dc.relation.citationendpage.spa.fl_str_mv 480
dc.relation.citationissue.spa.fl_str_mv 4
dc.relation.citationstartpage.spa.fl_str_mv 471
dc.relation.citationvolume.spa.fl_str_mv 36
dc.relation.ispartofjournal.spa.fl_str_mv Iatreia
dc.rights.uri.spa.fl_str_mv https://creativecommons.org/licenses/by-nc-sa/4.0/
dc.rights.uri.*.fl_str_mv http://creativecommons.org/licenses/by-nc-sa/2.5/co/
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dc.format.extent.spa.fl_str_mv 10 páginas
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dc.publisher.spa.fl_str_mv Universidad de Antioquia, Facultad de Medicina
dc.publisher.place.spa.fl_str_mv Medellín, Colombia
institution Universidad de Antioquia
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spelling Rosales Parra, Nicolas DayamAcero Murillo, Cristhian FabianUribe Munera, José AndrésRosales Parra, Miguel ÁngelTimarán Rodríguez, René Fernando2024-05-13T22:30:11Z2024-05-13T22:30:11Z2023Rosales-Parra ND, Uribe-Múnera JA, Timarán-Rodríguez RF, Acero-Murillo CF, Rosales-Parra MG. Early Outcomes in Major Amputation of Patients with Lower Limb Peripheral Arterial Disease: A Study in a Referral Hospital in Medellín, Colombia. Iatreia [Internet]. 2023 Oct-Dec;36(4):471-480. https://doi.org/10.17533/udea.iatreia.1990121-0793https://hdl.handle.net/10495/3927310.17533/udea.iatreia.1992011-7965https://revistas.udea.edu.co/index.php/iatreia/article/view/348853ABSTRACT: Introduction: Major amputation is a significant intervention in advanced stages of peripheral arterial disease (PAD) and has important morbidity and mortality rates. Despite being a frequently performed procedure in Colombia, local statistics on its frequency and outcomes are not available. Objectives: To analyze the morbidity and mortality in patients with lower limb PAD during the 30 days following major amputation or during the index hospitalization. To identify factors related to the outcome and characterize the population. Methods: A retrospective study of patients with lower limb PAD who underwent major amputation for acute ischemia (AI) or chronic limb-threatening ischemia (CLTI) between March 2011 and December 2019 at Hospital Universitario San Vicente Fundación in Medellín, Colombia (HUSVF). Variables related to the underlying disease and perioperative morbidity were calculated in a general analysis and by groups, according to the level of amputation. Results: A total of 558 major amputations were performed, 83.5% for CLTI. The overall mortality rate was 14.7%, with 32.6% in AI and 11.2% in CLTI. The most frequent complication was delirium (28.8%). After multivariate analysis, no influential factors were identified for fatal outcomes, except for cardiovascular complications in AI. Conclusions: In this study, the only variable related to early mortality was cardiovascular complications in patients with AI. The percentages of heart disease are lower compared to those reported in studies from other countries. The most common complication was delirium.RESUMEN: Introducción: la amputación mayor es una herramienta relevante en grados avanzados de la enfermedad arterial periférica (EAP) y tiene tasa importante de morbimortalidad. Aun siendo un procedimiento que se realiza frecuentemente en Colombia, no se dispone de estadísticas locales sobre su frecuencia y resultados. Objetivos: analizar la morbimortalidad en los pacientes con EAP de miem-bros inferiores durante los 30 días siguientes a la amputación mayor o durante la hospitalización índice. Determinar los factores relacionados con el desenlace y caracterizar la población. Métodos: estudio retrospectivo de pacientes con EAP de miembros inferiores que fueron llevados a amputación mayor por isquemia aguda (IA) o isquemia crónica que amenaza la extremidad (ICAE), entre marzo del 2011 y diciembre del 2019 en el Hospital Universitario San Vicente Fundación de Medellín, Colombia (HUSVF). Se calcularon las variables relacionadas con la enfermedad de base y morbilidad perioperatoria en un análisis general y por grupos, de acuerdo con el nivel de amputación. Resultados: se realizaron 558 amputaciones mayores, 83,5% por ICAE. La mortalidad global fue del 14,7%, del 32,6% en la IA y del 11,2% en la ICAE. La complicación más frecuente fue el delirium (28,8%). Tras el análisis multivariado no hubo factores influyentes en el desenlace fatal, salvo las complicaciones cardiovasculares en la IA. Conclusiones: en este estudio la única variable relacionada con la mortalidad temprana fueron las complicaciones cardiovasculares en pacientes con IA. Los porcentajes de cardiopatía son menores respecto a los reportados en estudios de otros países. La complicación más frecuente fue el delirium.10 páginasapplication/pdfengUniversidad de Antioquia, Facultad de MedicinaMedellín, Colombiahttps://creativecommons.org/licenses/by-nc-sa/4.0/http://creativecommons.org/licenses/by-nc-sa/2.5/co/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Early Outcomes in Major Amputations of Patients with Peripheral Arterial Disease of Lower Limbs: A Study in a Referral Hospital in Medellín, ColombiaDesenlaces tempranos en amputación mayor de pacientes con enfermedad arterial periférica de miembros inferiores. Estudio en un hospital de referencia en Medellín, ColombiaArtículo de investigaciónhttp://purl.org/coar/resource_type/c_2df8fbb1https://purl.org/redcol/resource_type/ARThttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionAmputation, SurgicalAmputación QuirúrgicaColombiaMorbidityMorbilidadMortalityMortalidadPeripheral Arterial DiseaseEnfermedad Arterial Periféricahttps://id.nlm.nih.gov/mesh/D000671https://id.nlm.nih.gov/mesh/D003105https://id.nlm.nih.gov/mesh/D009017https://id.nlm.nih.gov/mesh/D009026https://id.nlm.nih.gov/mesh/D058729Iatreia480447136IatreiaPublicationORIGINALRosalesNicolas_2023_EarlyOutcomesMajor.pdfRosalesNicolas_2023_EarlyOutcomesMajor.pdfArtículo de investigaciónapplication/pdf399678https://bibliotecadigital.udea.edu.co/bitstreams/5336af3c-7914-4bbc-9ce4-82284457e1b5/downloadd74f26f692bb435158ebe0230417ec64MD51trueAnonymousREADCC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-81051https://bibliotecadigital.udea.edu.co/bitstreams/d00718eb-7ac5-4a1e-8e57-f62445b7b8ac/downloade2060682c9c70d4d30c83c51448f4eedMD54falseAnonymousREADLICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://bibliotecadigital.udea.edu.co/bitstreams/7a13f4bc-68cc-4489-af4d-43ce684cfc70/download8a4605be74aa9ea9d79846c1fba20a33MD55falseAnonymousREADTEXTRosalesNicolas_2023_EarlyOutcomesMajor.pdf.txtRosalesNicolas_2023_EarlyOutcomesMajor.pdf.txtExtracted texttext/plain30261https://bibliotecadigital.udea.edu.co/bitstreams/efb9e15e-81fc-4f72-9772-f24be48504f3/download69a5912a8737720bcfb72d0a1c2172e5MD56falseAnonymousREADTHUMBNAILRosalesNicolas_2023_EarlyOutcomesMajor.pdf.jpgRosalesNicolas_2023_EarlyOutcomesMajor.pdf.jpgGenerated Thumbnailimage/jpeg12613https://bibliotecadigital.udea.edu.co/bitstreams/60b7602b-277a-4f89-acd5-a4c1c529750b/download09933a0deedadf4024622af3a946faf5MD57falseAnonymousREAD10495/39273oai:bibliotecadigital.udea.edu.co:10495/392732025-03-26 19:31:24.998https://creativecommons.org/licenses/by-nc-sa/4.0/open.accesshttps://bibliotecadigital.udea.edu.coRepositorio Institucional de la Universidad de Antioquiaaplicacionbibliotecadigitalbiblioteca@udea.edu.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