Burn and Wound Healing Unit, Faculté des Sciences de la Santé, University of Lomé, Lomé, Togo.
Sylvanus Olympio Teaching Hospital, Lomé, Togo.
J Orthop Surg Res. 2023 Mar 2;18(1):155. doi: 10.1186/s13018-023-03628-5.
We analysed the clinical, biological, radiological profiles, and therapeutic patterns of the patients who underwent a surgical lower extremity amputation (LEA) in Togo from 2010 to 2020.
Retrospective analysis of clinical files of adult patients who underwent an LEA at a single centre (Sylvanus Olympio Teaching Hospital) from 1st January 2010 to 31st December 2020. Data were analysed by CDC Epi Info Version 7 and Microsoft Office Excel 2013 software.
We included 245 cases. The mean age was 59.62 years (15.22 SD) (range: 15-90 years). The sex ratio was 1.99. The medical history of diabetes mellitus (DM) was found in 143/222 (64.41%) files. The amputation level found in 241/245 (98.37%) files was the leg in 133/241 (55.19%) patients, the knee in 14/241 (5.81%), the thigh in 83/241 (34.44%), and the foot in 11/241 (4.56%). The 143 patients with DM who underwent LEA had infectious and vascular diseases. Patients with previous LEAs were more likely to have the same limb affected than the contralateral one. The odds of trauma as an indication for LEA were twice as high in patients younger than 65 years compared to the older (OR = 2.095, 95% CI = 1.050-4.183). The mortality rate after LEA was 17/238 (7.14%). There was no significant difference between age, sex, presence or absence of DM, and early postoperative complications (P = 0.77; 0.96; 0.97). The mean duration of hospitalization marked in 241/245 (98.37%) files was 36.30 (1-278) days (36.20 SD). Patients with LEAs due to trauma had a significantly longer hospital admission than those with non-traumatic indications, F (3,237) = 5.505, P = 0.001.
Compared to previous decades, from 2010 to 2020, the average incidence of LEAs for all causes at Sylvanus Olympio Teaching Hospital (Lomé, Togo) decreased while the percentage of patients with DM who underwent LEAs increased. This setting imposes a multidisciplinary approach and information campaigns to prevent DM, cardiovascular diseases, and relative complications.
我们分析了 2010 年至 2020 年多哥接受下肢截肢手术（LEA）的患者的临床、生物学、影像学特征和治疗模式。
对 2010 年 1 月 1 日至 2020 年 12 月 31 日在单一中心（Sylvanus Olympio 教学医院）接受 LEA 的成年患者的临床档案进行回顾性分析。数据使用 CDC Epi Info 版本 7 和 Microsoft Office Excel 2013 软件进行分析。
我们纳入了 245 例患者。平均年龄为 59.62 岁（15.22 标准差）（范围：15-90 岁）。男女比例为 1.99。222 例病历中有 143 例（64.41%）有糖尿病史（DM）。245 例截肢水平中，241 例（98.37%）为腿部截肢 133 例（55.19%），膝关节截肢 14 例（5.81%），大腿截肢 83 例（34.44%），足部截肢 11 例（4.56%）。143 例患有 DM 的 LEA 患者有感染和血管疾病。既往接受过 LEA 的患者同一肢体再次受累的可能性高于对侧。与老年患者相比，65 岁以下患者因创伤而接受 LEA 的可能性是其两倍（OR=2.095，95%CI=1.050-4.183）。LEA 后的死亡率为 17/238（7.14%）。年龄、性别、是否存在 DM 以及术后早期并发症之间无显著差异（P=0.77；0.96；0.97）。241 例病历（98.37%）标记的平均住院时间为 36.30（1-278）天（36.20 标准差）。因创伤而接受 LEA 的患者的住院时间明显长于因非创伤性原因而接受 LEA 的患者，F（3，237）=5.505，P=0.001。
与前几十年相比，2010 年至 2020 年，Sylvanus Olympio 教学医院（多哥洛美）所有原因导致的 LEA 平均发病率下降，而接受 LEA 的 DM 患者比例上升。这种情况需要采取多学科方法和信息宣传活动，以预防糖尿病、心血管疾病和相关并发症。
