(DLS-033) Morbidity and mortality of the transmetatarsal amputation

Temitope Adebayo, MS-3 – Podiatric Medical Student, Temple University School of Podiatric Medicine; Kavya Ajbani, MS-3 – Podiatric Medical Student, Temple University School of Podiatric Medicine; Russell Hill, DPM, PGY-3 – Resident, Temple University Hospital Podiatric Surgical Residency Program; Benita Jebackumar, MS-3 – Podiatric Medical Student, Temple University School of Podiatric Medicine

Introduction: Diabetic foot ulcers are commonly treated with amputations, especially when infection or osteomyelitis is involved. Transmetatarsal amputation is one of the most common procedures performed in diabetic limb preservation to save the limb and achieve a functional foot. TMA appears to be a highly effective procedure amongst other minor amputations. Although extensive peri and postoperative assessment needs to be performed for this procedure. This procedure carries risks of morbidity and mortality like many other common surgical procedures. The associated morbidity and mortality of these surgical procedures are important to consider in perioperative risk assessment and surgical planning.

Methods: This study individually compared the probability of morbidity and mortality in transmetatarsal amputation to other common surgical interventions using a large US database; the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database. TMA was compared to 17 procedures identified as common procedures with a frequency of over 10,000 using this database, and the probability of morbidity and mortality for these cases was evaluated using logistic regression analysis.

Results: The results show that TMA was associated with the second highest estimated probability of mortality compared to all the other procedures second to hip fracture treatments and TMA was associated with the highest estimated probability of morbidity compared to the other procedures.

Discussion: Although amputation is typically a necessary treatment option for many patients with diabetes, this study shows that it may still lead to increased mortality risks. From the results of this study, we concluded that TMA carries significant morbidity and mortality compared to many other surgical procedures.