Death And Amputation

The following abstract is reprinted from the October 1968 issue of Braces Today, the newsletter of the Pope Foundation, Inc.

In a study of the causes of mortality associated with amputations of ischemic extremities an investigating team at the University of Oregon, Portland, found that in a group of 103 patients operated on between 1938 and 1945 the mortality rate was 46.8 per cent. They compared this rate with that of another group who underwent amputation between 1946 and 1950, in which the mortality rate was 22.8 per cent and a final group, 1952 to 1967, in which the rate was 19.7.

Pointing out that there was no significant change in the latter 2 groups, the authors (Larry R. Eidemiller, M.D., William C. Awe, M.D., and Clare G. Peterson, M.D.) sought answers to 2 questions: (a) the question of the causes of death following amputation of ischemic limbs, and (b) the question of whether or not the high mortality rates are inevitable because of the nature of the case material or whether there are factors that can be identified and corrected.

Their conclusions are published in THE AMERICAN SURGEON (34:491, 1968). The causes of death following amputation in 85 patients with circulatory ailments were: pneumonia, 24 patients (28 per cent); "cardiovascular collapse," 20 patients (23 percent); myocardial infarction, 8 patients (9.5 per cent); mesenteric thrombosis, 5 patients; septicemia, 5; cerebral infarction, 3; and unknown and miscellaneous, 9. Thus, 67 percent of the deaths were cardiopulmonary in origin. The authors suggest that reduction of mortality will depend on an increased awareness of the high risk presented by patients of this kind, with special alertness to the possibility of pneumonia so that it can be treated early, and by prospective clinical studies aimed at developing effective preventive measures against pulmonary embolism.