Patient selection: adult with a below-the-knee amputation in the National Surgical Quality Improvement Program database. The average age was 66 years. Almost 70% had peripheral arterial disease (? accuracy) and 96% were ASA III or higher. Most patients were male Caucasians.
Major complications: wound infection, cardiopulmonary complications, deep vein thrombosis, thromboembolic disease, stroke, sepsis, reoperation
Risk factors for 30-day mortality:
(1) renal insufficiency
(2) cardiac disease (congestive heart failure within 30 days and/or myocardial infarction within past 6 months)
(3) preoperative sepsis (within 48 hours before surgery)
(4) therapy with corticosteroids
(5) chronic obstructive pulmonary disease (COPD)
(6) advanced age (>= 70 years arbitrarily used in the implementation)
Risk factors for 30-day morbidity:
(1) renal insufficiency
(2) cardiac disease (congestive heart failure within 30 days and/or myocardial infarction within past 6 months)
(3) preoperative sepsis (within 48 hours before surgery)
(4) therapy with corticosteroids
(5) contaminated or infected wounds
(6) regular alcohol use (more than 2 drinks per day in the 2 weeks prior to hospital admission)
