Prevalence and Causes for Lower Limb Amputation at the National Hospital Galle

Abstract

Background: Lower limb amputation (LLA) has become a burden worldwide high morbidity and mortality rates. Objective: To assess the prevalence and causes of LLA among the surgical patients admitted to the National Hospital Galle (NHG) Methods: A retrospective, observational study was conducted at NHG. The bed head tickets of the patients admitted to the general surgical wards of NHG during January 2018 and December 2023 were reviewed to identify the patients underwent lower limb amputation and related causes. Results: During the given period, the total admissions to the general surgical wards were 145,700. Of them, 685 patients had undergone LLA which accounts for 470 persons with amputations per 100,000 of admissions to the general surgical wards in the hospital. A total of 690 LLA had been performed in 685 patients during this period with 05 patients experienced more than one amputation. The mean±SD age of the amputees was 62.10±14.71 years. Majority of them (n=425, 62%) were males. Diabetes mellitus related peripheral vascular disease was the main cause for LLA in 72.7% (n=500) while only 1.9% (n=13) was due to malignancy, mainly osteogenic sarcoma,13.9% was due to trauma (n=95), 5.4% (n=37) was due to ischemia and 6.1% (n=42) was due to infection. Of them, 64.4% (n=441) of the amputations were below knee amputations, 25% (n=171) were above knee amputations and 8.3% (n=57) were fore-foot amputations, 1.6% (n=11) were hip disarticulations and 0.7% (n=5) were through knee amputations. Amputation among young ages were mainly due to trauma and malignancy while diabetes mellitus related peripheral vascular disease, ischemic related amputation were main causes in elderly patients in their sixth, seventh and eight decades. In comparison, the amputation frequency has increased by 100% from 92 in 2018 to 184 in 2023. Conclusion: LLA is highly prevalent among surgical patients admitted to NHG, primarily due to peripheral vascular disease related to diabetes mellitus.