Brix Anna Trier Heiberg, Rubin Katrine Hass, Nymark Tine, Schmal Hagen, Lindberg-Larsen Martin
Department of Orthopedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN - Open Patient Data Explorative Network, Odense University Hospital and University of Southern Denmark, Odense, Denmark.
Acta Orthop. 2024 Dec 23;95:737-743. doi: 10.2340/17453674.2024.42637.
Major lower extremity amputation (MLEA) is associated with complications that may prolong length of hospital stay (LOS) and increase the risk of readmission. We primarily aimed to examine the LOS and risk of readmissions after MLEA in Denmark. Secondarily we investigated the time trends.
Using Danish National Patient Registry data, this observational study analyzed 11,205 first-time MLEAs (35% transtibial amputations, 65% transfemoral amputations) performed between January 1, 2010 and December 31, 2021. Total LOS included pre- and postoperative nights. The first readmission within 30 days and 90 days post-discharge was analyzed.
The median total LOS after a transtibial amputation was 19 days (interquartile range [IQR] 11-30), and decreased from 28 days (IQR 17-41) in 2010 to 14 days (IQR 9-23) in 2021. The median total LOS after a transfemoral amputation was 13 days (IQR 8-22) and decreased from 16 days (IQR 9-27) in 2010 to 11 days (IQR 7-18) in 2021. Post-discharge readmission risks within 30 days were 27% (95% confidence interval [CI] 24-28) for transtibial amputations and 23% (CI 22-24) for transfemoral amputations, with corresponding 90-day risks of 40% (CI 39-42) and 35% (CI 34-36), respectively. The 30-day risk of readmission increased in both groups.
We observed that MLEA patients' hospital admissions lasted 2-3 weeks and decreased over the study period. A readmission risk of 23-27% within 30 days and 35-40 % within 90 days post-discharge was observed. Readmissions risk increased for both initial transtibial and transfemoral amputations over the study period.
下肢大截肢（MLEA）会引发一些并发症，可能会延长住院时间（LOS）并增加再次入院风险。我们的主要目的是研究丹麦下肢大截肢后的住院时间和再次入院风险。其次，我们调查了时间趋势。
利用丹麦国家患者登记数据，这项观察性研究分析了2010年1月1日至2021年12月31日期间进行的11205例首次下肢大截肢手术（35%为经胫骨截肢，65%为经股骨截肢）。总住院时间包括术前和术后的夜晚。分析了出院后30天和90天内的首次再次入院情况。
经胫骨截肢后的总住院时间中位数为19天（四分位间距[IQR]11 - 30），从2010年的28天（IQR 17 - 41）降至2021年的14天（IQR 9 - 23）。经股骨截肢后的总住院时间中位数为13天（IQR 8 - 22），从2010年的16天（IQR 9 - 27）降至2021年的11天（IQR 7 - 18）。经胫骨截肢后30天内出院后再次入院风险为27%（95%置信区间[CI]24 - 28），经股骨截肢为23%（CI 22 - 24），相应的90天风险分别为40%（CI 39 - 42）和35%（CI 34 - 36）。两组的30天再次入院风险均有所增加。
我们观察到下肢大截肢患者的住院时间持续2至3周，且在研究期间有所减少。观察到出院后30天内再次入院风险为23% - 27%，90天内为35% - 40%。在研究期间，初次经胫骨和经股骨截肢的再次入院风险均有所增加。
