JOPIC
Journal of Pulmonology and Intensive Care

The JoPIC is an independent-unbiased, peer-reviewed, and open-access journal of current national and international issues and reviews for original clinical and experimental research, interesting case reports, surgical techniques, differential diagnoses, editorial opinions, letters to the editor, and educational papers in pulmonology, thoracic surgery, occupational diseases, allergology, and intensive care medicine.

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Original Article
Evaluation of factors associated with mortality after major lower extremity amputation: implications for intensive care
Abstract
Aims: Amputations performed proximal to the ankle level are defined as major lower extremity amputation (MLEA) and are associated with high postoperative mortality. This study aimed to evaluate the clinical characteristics, laboratory findings, and postoperative complications associated with 30-day and six-month mortality in patients undergoing MLEA for different etiologies.
Methods: The electronic medical records of 419 patients aged 18 years or older who underwent surgery for MLEA between November 2022 and November 2025 were retrospectively analyzed. Patients’ demographic data, American Society of Anesthesiologists (ASA) physical status classification, comorbidities, laboratory parameters, length of hospital stay, and 30-day and six-month mortality data were recorded. Patients were divided into two groups according to mortality status. For the 30-day and six-month mortality analyses, patients were separately grouped according to their survival status during the respective follow-up period.
Results: Data from 419 patients were analyzed. Thirty-day mortality occurred in 54 patients (12.9%), and 6-month mortality occurred in 109 patients (26.0%). In the multivariable analysis, postoperative pulmonary complications (adjusted OR, 3.16; 95% CI, 1.77-5.64; p<0.001), older age (adjusted OR, 1.05; 95% CI, 1.03-1.07; p<0.001), higher preoperative creatinine levels (adjusted OR, 1.21; 95% CI, 1.04-1.40; p=0.013), and higher C-reactive protein-to-albumin ratio (CAR) (adjusted OR, 1.08; 95% CI, 1.02-1.14; p=0.005) were independently associated with 6-month mortality. Older age (adjusted OR, 1.030; 95% CI, 1.005-1.056; p=0.019), postoperative pulmonary complications (adjusted OR, 3.993; 95% CI, 2.042-7.806; p<0.001), and higher CAR (adjusted OR, 1.097; 95% CI, 1.030-1.169; p=0.004) were independently associated with 30-day mortality.
Conclusion: Advanced age, elevated preoperative CAR, and postoperative pulmonary complications were independently associated with both early- and intermediate-term mortality after MLEA.

Keywords : Amputation; surgical, lower extremity, mortality

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Ethical Statement

This study was conducted with the approval of the No. 2 Scientific Researches Evaluation and Ethics Committee of Ankara Etlik City Hospital (Date: 30.06.2026, Decision No: AESH-BADEK2-2026-531).

Informed Consent

As this was a retrospective study, formal written informed consent was not required and was therefore not obtained. This retrospective study used pre-existing anonymized patient data. No additional intervention was performed, and there was no direct patient contact. The study was approved by the Ethics Committee, and the requirement for written informed consent was waived by the ethics committee.

Author Contributions

Concept: FA; Design: FA; Control: FÖS; Resources: FA, FÖS; Materials: FA, FÖS; Data Collection and/or Processing: FA, FÖS; Analysis and/or Interpretation: FA, FÖS; Literature Review: FA; Article Writing: FA, FÖS; Critical Review: FÖS.

Conflict of Interest

The authors declare no conflicts of interest related to this study.

Financial Disclosure

The authors received no financial support for the conduct or publication of this research.


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Article available in :
Volume 4, Issue 4, 2026
Page : 95-101
https://doi.org/10.51271/JOPIC-0088
Article Information
Received : 14 Tem 2026
Accepted : 15 Ağu 2026
Published : 28 Eki 2026
Corresponding Author :

Funda Atar: Department of Anesthesiology and Reanimation, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Atar F, Özkan Sipahioğlu F. Evaluation of factors associated with mortality after major lower extremity amputation: implications for intensive care. J Pulmonol Intens Care. 2026;4(4):95-101. doi:10.51271/JOPIC-0088

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