Chronic kidney disease predicts long-term mortality after major lower extremity amputation

Roland Assi, Yorg Al Azzi, Clinton D. Protack, Willis T. Williams, Michael R. Hall, Daniel J. Wong, Daniel Y. Lu, Penny Vasilas, Alan Dardik

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: Despite low peri-operative mortality after major lower extremity amputation, long-term mortality remains substantial. Metabolic syndrome is increasing in incidence and prevalence at an alarming rate in the USA. Aim: This study was to determine whether metabolic syndrome predicts outcome after major lower extremity amputation. Patients and Methods: A retrospective review of charts between July 2005 and June 2010. Results: Fifty-four patients underwent a total of 60 major lower extremity amputations. Sixty percent underwent below-knee amputation and 40% underwent above-knee amputation. The 30-day mortality was 7% with no difference in level (below-knee amputation, 8%; above-knee amputation, 4%; P = 0.53). The mean follow-up time was 39.7 months. The 5-year survival was 54% in the whole group, and was independent of level of amputation (P = 0.24) or urgency of the procedure (P = 0.51). Survival was significantly decreased by the presence of underlying chronic kidney disease (P = 0.04) but not by other comorbidities (history of myocardial infarction, P = 0.79; metabolic syndrome, P = 0.64; diabetes mellitus, P = 0.56). Conclusion: Metabolic syndrome is not associated with increased risk of adverse outcomes after lower extremity amputation. However, patients with chronic kidney disease constitute a sub-group of patients at higher risk of postoperative long-term mortality and may be a group to target for intervention.

Original languageEnglish (US)
Pages (from-to)321-327
Number of pages7
JournalNorth American Journal of Medical Sciences
Issue number7
StatePublished - Jul 2014
Externally publishedYes


  • Chronic kidney disease
  • Lower extremity amputation
  • Metabolic syndrome
  • Mortality
  • Peripheral artery disease

ASJC Scopus subject areas

  • Medicine(all)


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