Geriatic lower limb amputations in a tertiary health centre in Southwestern Nigeria: a 5-year retrospective cohort study

Mosimabale J. Balogun; Jemiludeen O. Morhason-Bello; Rahaman A. Afolabi; Idowu K. Olusola

doi:10.18203/2320-6012.ijrms20251273

Authors

Mosimabale J. Balogun Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
Jemiludeen O. Morhason-Bello Department of Orthopeadic and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria
Rahaman A. Afolabi Department of Orthopeadic and Trauma, University College Hospital, Ibadan, Oyo State, Nigeria
Idowu K. Olusola Department of Anaesthesia, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria

DOI:

https://doi.org/10.18203/2320-6012.ijrms20251273

Keywords:

Amputations, Geriatric, Lower limb

Abstract

Background: Amputation in the geriatric population is a significant health concern with overmastering implications for individual well-being, healthcare systems, and societal resources. The aim was to review all geriatric patients who had lower limb amputation over a 5-year period.

Methods: Retrospective cohort study which examined 54 elderly patients aged 65 years and older who underwent lower limb amputation in a 5year period. Data on demographics, clinical characteristics, and surgical details were extracted from medical records.

Results: The mean age of patients was 73.9 years, with 61.1% between 65-74 years old. There was an equal distribution of males and females. The left lower limb was more commonly affected (53.7%) than the right (44.4%). Diabetic foot was the leading cause of amputation (66.7%), followed by peripheral arterial disease (31.5%).

Conclusions: This study highlights the significant impact of diabetes and peripheral arterial disease on lower limb amputations in the elderly population. The findings underscore the need for targeted interventions in diabetes management and vascular health to reduce amputation risk. Further research is warranted to investigate the slight predominance of left lower limb amputations and to develop strategies for improving outcomes in this vulnerable population.

Metrics

Metrics Loading ...

References

Fuster V. Changing Demographics: A New Approach to Global Health Care Due to the Aging Population. J Am Coll Cardiol. 2017;69(24):3002–5. DOI: https://doi.org/10.1016/j.jacc.2017.05.013

Population NRC (US) Panel on Statistics for an Aging Population, Gilford DM. Social, Economic, and Demographic Changes among the Elderly. 1988.

Thiruvoipati T, Kielhorn CE, Armstrong EJ. Peripheral artery disease in patients with diabetes: Epidemiology, mechanisms, and outcomes. World J Diabetes. 2015;6(7):961. DOI: https://doi.org/10.4239/wjd.v6.i7.961

Zhao R, Liang H, Clarke E, Jackson C, Xue M. Inflammation in Chronic Wounds. Int J Mol Sci. 2016;17(12):2085. DOI: https://doi.org/10.3390/ijms17122085

Anigbamkpu SO. The profile of geriatric extremity amputation in a low-and-middle-income country. East Afr Orthop J. 2023;17.

Fiedler G, Akins J, Cooper R, Munoz S, Cooper RA. Rehabilitation of People with Lower-Limb Amputations. Curr Phys Med Rehabil Rep. 2014;2(4):263–72. DOI: https://doi.org/10.1007/s40141-014-0068-8

Peters CML, de Vries J, Veen EJ, de Groot HGW, Ho GH, Lodder P, et al. Is amputation in the elderly patient with critical limb ischemia acceptable in the long term? Clin Interv Aging. 2019;14:1177. DOI: https://doi.org/10.2147/CIA.S206446

Moxey PW, Hofman D, Hinchliffe RJ, Jones K, Thompson MM, Holt PJE. Epidemiological study of lower limb amputation in England between 2003 and 2008. Br J Surg. 2010;97(9):1348-53. DOI: https://doi.org/10.1002/bjs.7092

Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R. Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050. Arch Phys Med Rehabil. 2008;89(3):422-9. DOI: https://doi.org/10.1016/j.apmr.2007.11.005

Aulivola B, Hile CN, Hamdan AD, Sheahan MG, Veraldi JR, Skillman JJ, et al. Major Lower Extremity Amputation: Outcome of a Modern Series. Arch Surg. 2004;139(4):395-9. DOI: https://doi.org/10.1001/archsurg.139.4.395

Moulik PK, Mtonga R, Gill GV. Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology. Diabetes Care. 2003;26(2):491-4. DOI: https://doi.org/10.2337/diacare.26.2.491

Boulton AJM, Kirsner RS, Vileikyte L. Neuropathic diabetic foot ulcers. N Engl J Med. 2004;351(1):48-55. DOI: https://doi.org/10.1056/NEJMcp032966

Dormandy JA. Management of peripheral arterial disease (PAD). J Vasc Surg. 2000;31:S1-296.

Oliver D, Healey F. Preventing falls and fall-related injuries in hospitals. Clin Geriatr Med. 2010;26(4):645-92. DOI: https://doi.org/10.1016/j.cger.2010.06.005

Guay J, Parker MJ, Gajendragadkar PR, Kopp S. Anaesthesia for hip fracture surgery in adults. Cochrane Database Syst Rev. 2016 Feb 22;2016(2). DOI: https://doi.org/10.1002/14651858.CD000521.pub3

Escamilla-Nunez R, Michelini A, Andrysek J. Biofeedback systems for gait rehabilitation of individuals with lower-limb amputation: a systematic review. Sensors (Basel). 2020;20(6). DOI: https://doi.org/10.3390/s20061628