A systematic review conducted by researchers from La Trobe University and the University of Washington explores mortality rates following dysvascular partial foot amputation (PFA) and transtibial amputation (TTA). Understanding the differences in mortality rates between different levels of amputation can help guide patients and healthcare providers in making amputation decisions. Partial foot amputation involves removing part of the foot, while transtibial amputation involves removing the leg below the knee, a more extensive procedure.
The review included peer-reviewed studies published between January 1, 2016, and April 12, 2024, that measured proportionate mortality following dysvascular amputations. In total, seventeen studies met the inclusion criteria.
The findings revealed that mortality rates following dysvascular PFA increased significantly over time, with 2.1% of patients dying within 30 days, 13.9% within 1 year, 30.1% within 3 years, and 42.2% within 5 years. Additionally, a comparative study highlighted a higher relative risk of dying within one year after TTA compared to PFA (relative risk 1.51).
The review concluded that proportionate mortality has remained consistent in recent years. These results are comparable to a previous review that looked at studies up to December 2015. This important data can be used in decision aids that support conversations between healthcare providers and patients about the choice of amputation level.
The study was authored by Stefania Fatone, PhD, Professor, as well as colleagues from La Trobe University in Australia. The study is online now in Disability and Rehabilitation.