While Mortality Rates Differ After Dysvascular Partial Foot and Transtibial Amputation, Should They Influence the Choice of Amputation Level?

Michael Dillon, Stefania Fatone*, Matthew Quigley

*Corresponding author for this work

Research output: Contribution to journalComment/debatepeer-review

1 Scopus citations

Abstract

Although there is strong evidence to show that the risk of dying after transtibial amputation is higher than partial foot amputation, we are concerned by the implication that amputation level influences mortality, and that such interpretations of the evidence may be used to inform decisions about the choice of amputation level. We argue that the choice of partial foot or transtibial amputation does not influence the risk of mortality. The highest mortality rates are observed in studies with older people with more advanced systemic disease and multiple comorbidities. Studies that control for the confounding influence of these factors have shown no differences in mortality rates by amputation level. These insights have important implications in terms of how we help inform difficult decisions about amputation at either the partial foot or transtibial level, given a more thoughtful interpretation of the published mortality rates.

Original languageEnglish (US)
Pages (from-to)1900-1902
Number of pages3
JournalArchives of physical medicine and rehabilitation
Volume98
Issue number9
DOIs
StatePublished - Sep 2017

Keywords

  • Amputation
  • Decision making
  • Mortality
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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