Impact of delayed amputation on clinical outcomes compared to that of early amputation in patients with blunt polytrauma

Abstract

Abstract Delayed amputation after failed limb salvage can lead to negative clinical and functional outcomes due to complications, including re-amputation. This study aimed to compare clinical outcomes and identify risk factors according to the timing of amputation. A retrospective review of lower-extremity injuries managed between January 2016 and December 2022 at a level 1 trauma center was conducted. Outcomes were compared between early amputation (within 48 h) and delayed amputation (beyond 48 h) groups. The primary outcome was the risk of a more proximal amputation level according to the timing of amputation. Secondary outcomes included trauma-related complications and clinical outcomes. Trauma-related complications were more common in the delayed amputation group, with no significant differences in 30-day mortality. Delayed amputation and deep surgical infection at the stump site were associated with higher odds of a more proximal amputation level than initially predicted. The overall hospital stay was significantly longer in the delayed amputation group. While there is no established standard for deciding between limb salvage and amputation strategies, delayed amputation could be a risk factor for shorter limb stumps owing to re-amputation, and patients may experience more trauma-related complications and prolonged hospitalization.