Assessment of the outcome of lower limb amputations as seen in Kenyatta National Hospital

Abstract

This study was designed to assess the outcome of lower limb amputations as managed at the Kenyatta National Hospital. A prospective analysis of consecutive patients who underwent lower limb amputations at the Kenyatta National Hospital between July 1st, 2003 and June 30th, 2004 was performed. Data on the management and outcome were collected using questionnaires administered to the patients while admitted and in the follow-up clinics. The main outcome measures were the duration of hospital stay, duration of wound healing, need for operative revision, need to convert to a higher amputation level, degree of mobility and the thirty-day postoperative mortality. A total of74 patients (46 males) underwent 77 lower limb amputations. The mean age at operation was 44.4 years (range 7 months - 96 years). Ninety one percent were major amputations; 42 AKA ( 3 bilateral), 24 BKA and 4 hip disarticulations. Open amputations comprised 23% of the total. Extremity gangrene due to peripheral vascular diseases was the main indication for amputation (55%). Anaemia was the most common co-morbid condition (27%) followed by diabetes (18%), while stump infection was the commonest complication (33%). The thirty-day mortality rate was 13.5%. The healing rate for BKA was significantly less than for AKA, with a 21% rate of eventual conversion of BKA to AKA. Most of the patients (70%) were ambulating on crutches The average duration of hospital stay was 29.3 days. There was no patient who was using a prosthetic limb during the study period.