Evidence map›Paper›PMID 30675076›Full record

ArticleThe Ulster medical journal2019

All-Cause Mortality Amongst Patients Undergoing Above and Below Knee Amputation in a Regional Vascular Centre within 2014-2015.

Gem Kennedy, K McGarry, G Bradley, D W Harkin

Abstract read
In one paragraph

Article in The Ulster medical journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Gem KennedyThe Vascular Centre, Royal Victoria Hospital Belfast. Royal Victoria Hospital, Belfast Health and Social Care Trust, 274 Grosvenor Rd, Belfast BT12 6BA. N. Ireland.
K McGarryThe Vascular Centre, Royal Victoria Hospital Belfast. Royal Victoria Hospital, Belfast Health and Social Care Trust, 274 Grosvenor Rd, Belfast BT12 6BA. N. Ireland.
G BradleyDepartment of Paleontology. Faculty of Earth and Atmospheric Science. University of Alberta 1-26 Earth Sciences Building. Edmonton, Alberta T6G 2E3 Canada.
D W HarkinThe Vascular Centre, Royal Victoria Hospital Belfast. Royal Victoria Hospital, Belfast Health and Social Care Trust, 274 Grosvenor Rd, Belfast BT12 6BA. N. Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMajor lower limb amputation remains a common treatment for patients with peripheral vascular disease (PVD) in whom other measures have failed. It has been associated with high morbidity and mortality, including risks from venous thromboembolism (VTE).

methodsA two-year retrospective cohort study was conducted involving 79 patients who underwent major lower limb amputation (below- or above-knee amputation) between January 2014 and December 2015 in a single tertiary referral centre. Amputation procedures were performed for reasons relating to complications of PVD and/or diabetes mellitus. Patients were followed-up to investigate all-cause mortality rates and VTE events using the Northern Ireland Electronic Care Record database (mean follow-up time 17 months).

resultsOf the 79 patients, there were 52 male and 27 female. Mean age at time of surgery was 72 years (range 34-99 years). Forty-six patients (58%) suffered from diabetes mellitus, 29 (35%) heart failure, 31 (39%) chronic kidney disease (CKD) and 10 (13%) chronic obstructive pulmonary disease (COPD). Twenty patients (25%) were on anticoagulant therapy, and 53 (67%) were on antiplatelet therapy.Thirty-five patients (44%) died during follow-up; mean age at death was 74 years. No statistically significant association was found between mortality rate and the level of amputation (p=0.3702), gender (p=0.3507), or comorbid diabetic mellitus (p=0.1127), heart failure (p=0.1028), CKD (p=0.0643) or COPD (p=0.4987).Two patients experienced radiologically-confirmed non-fatal pulmonary emboli and two patients developed radiologically-confirmed deep vein thrombosis.

conclusionsThe results are in agreement with current literature that amputation is associated with significant mortality, with almost half of the study population dying during follow-up. Further work should explore measures by which mortality rates may be reduced.

Indexed as

AdultAgedAged, 80 and overAmputation, SurgicalCause of DeathDiabetes ComplicationsFemaleHumansKaplan-Meier EstimateLower ExtremityMaleMiddle AgedNorthern IrelandPeripheral Vascular DiseasesPostoperative ComplicationsRetrospective StudiesAll-Cause MortalityAmputationDeep Vein ThrombosisPulmonary EmbolismVascular Surgery

Identifiers

PMID30675076
PMCPMC6342035

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.