Hofmann Amun Georg, Greistorfer Emanuel, Taher Fadi, Assadian Afshin, Leinweber Maria Elisabeth
Department of Vascular and Endovascular Surgery, Klinik Ottakring, Montleartstrasse 37, 1160 Vienna, Austria.
J Clin Med. 2025 Apr 11;14(8):2640. doi: 10.3390/jcm14082640.
: Apart from their high burden of disease, major amputations, especially due to macro- and microangiopathic malperfusion, persist to inflict a relevant socioeconomic impact in most geographic regions. It has been repeatedly shown that lower extremity amputations are associated with impaired post-operative survival. In the present study, we investigated whether metrics derived from routine laboratory studies after amputation are associated with post-operative survival. : In this retrospective single-center analysis, 244 patients undergoing lower extremity amputation between 2012 and 2016 were included. Serum hemoglobin and leukocyte counts of the first 21 post-operative days as well as derived metrics were analyzed in addition to clinical and demographic variables. Kaplan-Meier estimates and adjusted Cox regressions were fitted including relevant parameters. : In summary, 71.3% of patients underwent transtibial and 28.7% transfemoral amputations. The most frequent post-operative complications were wound-related (43.0%). Long-term survival analyses showed that advanced age and higher ASA class were significantly associated with reduced post-operative survival, while no significant survival differences were observed based on sex, smoking history, or type of amputation. Laboratory parameter analysis showed impaired peri-operative outcomes in patients with elevated leukocyte counts, with leukocyte-derived metrics showing significant associations with long-term survival after adjustment for age and ASA class. : This study highlights the potential of routine laboratory parameter-derived metrics in predicting mortality after major lower extremity amputations in PAD patients.
除了疾病负担沉重外，大截肢手术，尤其是由于大血管和微血管病变导致的灌注不良，在大多数地理区域仍然造成重大的社会经济影响。反复研究表明，下肢截肢与术后生存率受损有关。在本研究中，我们调查了截肢后常规实验室检查得出的指标是否与术后生存率相关。
在这项回顾性单中心分析中，纳入了2012年至2016年间接受下肢截肢的244例患者。除了临床和人口统计学变量外，还分析了术后前21天的血清血红蛋白和白细胞计数以及得出的指标。拟合了Kaplan-Meier估计值和调整后的Cox回归，并纳入了相关参数。
总之，71.3%的患者接受了经胫骨截肢，28.7%接受了经股骨截肢。最常见的术后并发症与伤口有关（43.0%）。长期生存分析表明，高龄和较高的美国麻醉医师协会（ASA）分级与术后生存率降低显著相关，而基于性别、吸烟史或截肢类型未观察到显著的生存差异。实验室参数分析显示，白细胞计数升高的患者围手术期结局受损，白细胞衍生指标在调整年龄和ASA分级后与长期生存显著相关。
本研究强调了常规实验室参数得出的指标在预测外周动脉疾病（PAD）患者下肢大截肢术后死亡率方面的潜力。
