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Autor:
Dr.
Alberto García
E-mail:
agarciam@telesat.com.co
Cali, Colombia |
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AMPUTATION RISK AFTER SURGICAL
TREATMENT OF POPLITEAL VESSEL TRAUMA
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Objective
to identify risk factors of amputation after
surgical treatment of popliteal vessel
trauma.
Design
Retrospective cohort study.
Setting
University Hospital in Cali, Colombia.
Patients
176 individuals, 159 men and 17 women,
between the ages of 5 and 75 years (mean
27,7 SD+/-11,4), were treated surgically
from January 1992 to December 2004. The
mechanisms were gunshot in 104 cases,
shotgun in 15, stabwounds in 16 and blunt
trauma in 37. Amputation was performed in 27
patients (15,3%).
Measurements and results
A chart revision was performed. Demographic
data, trauma characteristics and details of
the treatment were tabulated. Bivariate
analysis was performed, taking amputation as
a dependent variable. Candidate risk factors
identified by a p< 0.1, (shown in the
table), were included in MLR models.
|
Variable |
Present n (%) |
Amputation n (%) |
R.R. |
I.C.95% |
p |
|
Blunt Trauma |
37 (21,0) |
12 (32,4) |
3.01 |
1.54- 5.86 |
0.001 |
|
Ischemia or pulse absent |
98 (55,7) |
24 (24,5) |
6.37 |
1.99- 20.37 |
<0.001 |
|
Fracture |
78 (44,3) |
19 (24,4) |
2.98 |
1.38- 6.45 |
0.003 |
|
Peripheral nerve trauma |
31 (17,6) |
8 (25,8) |
1.97 |
0.95- 4.08 |
0.075 |
|
Interval to surgery >6h |
76 (43,2) |
18 (23,7) |
2.63 |
1.25- 5.53 |
0.007 |
|
MESS >4 |
71 (40,3) |
23 (32,5) |
8.5 |
3.07- 23-54 |
<0.001 |
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Venous ligation |
37 (21.0) |
11 (29,7) |
2.58 |
1.24- 5.08 |
0.006 |
|
Fascitomy |
104 (59,1) |
22(21,2) |
2.98 |
1.38- 6.45 |
0.003 |
MLR identified blunt trauma, ischemia or pulse absent, time elapsed
before surgery, venous ligature and MESS >4,
as risk factors.
Conclusion:
Trauma severity, ischemia duration and
venous ligature related to amputation risk
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