Meta-analysis of prognostic factors for amputation following surgical repair of lower extremity vascular XXXX .

@entity1545 @entity1 @entity174 @entity2054 @entity1317 @entity130
BACKGROUND: @entity1545 ( @entity1545 ) is a major cause of amputation. A clear understanding of prognostic factors for amputation is important to inform surgical decision-making, @entity1 counselling and risk stratification. The aim was to develop an understanding of prognostic factors for amputation following surgical repair of @entity1545 . METHODS: A systematic review was conducted to identify potential prognostic factors. Bayesian meta-analysis was used to calculate an absolute (pooled proportion) and relative (pooled odds ratio, OR) measure of the amputation risk for each factor. RESULTS: Forty-five studies, totalling 3187 discrete @entity1545 repairs, were included. The overall amputation rate was 10  0 (95 per cent credible interval 7  4 to 13  1) per cent. Significant prognostic factors for secondary amputation included: associated major soft tissue injury (26 versus 8 per cent for no soft tissue injury; OR 5  80), @entity2054 (28 versus 6 per cent; OR 5  11), multiple @entity1317 (18 versus 9 per cent; OR 4  85), duration of ischaemia exceeding 6   h (24 versus 5 per cent; OR 4  40), associated @entity174 (14 versus 2 per cent; OR 4  30), mechanism of injury (blast 19 per cent, blunt 16 per cent, penetrating 5 per cent), anatomical site of injury (iliac 18 per cent, popliteal 14 per cent, tibial 10 per cent, femoral 4 per cent), age over 55   years (16 versus 9 per cent; OR 3  03) and sex ( @entity1 7 per cent versus @entity1 8 per cent; OR 0  64). Shock and nerve or @entity1317 were not significant prognostic factors for secondary amputation. CONCLUSION: A significant proportion of @entity1 who undergo lower extremity vascular @entity130 repair will require secondary amputation. This meta-analysis describes significant prognostic factors needed to inform surgical judgement, risk assessment and @entity1 counselling.
