Results

A total of 1,744 patients were identified, as summarized (descriptive analyses) in Table 1 and Figure 1. The annual average age ranged from 61.56 to 68.8 years, with an overall mean of 64.82 years (SD = 16.45; median = 67 years) (Figure 2). Mortality occurred in 123 (19.46%) of 632 female patients and 204 (18.34%) of 1,112 male patients; this difference was not statistically significant (chi-square test: p = 0.56). A total of 327 deaths were recorded, with annual mortality rates ranging from 11.45% to 25.5%. The highest mortality rate occurred in 2021, which was the period most affected by the COVID-19 pandemic at the institution. The mean annual mortality rate was 19.02%. During the non-COVID-19 period (2010-2019), 234 deaths occurred among 1,108 patients (21.12%), while during the pandemic period (2021-2022), there were 75 deaths among 408 patients (18.38%) (Figure 3). No statistically significant difference (Yates-corrected chi-square test: p = 0.5) was observed between these two groups (COVID-19 and non-COVID-19 groups).

Year | Amputations, female | Amputations, male | Amputations, Total | Perioperative deaths (N) | Perioperative deaths (%)
2010 | 23 | 43 | 66 | 19 | 28.79
2011 | 37 | 79 | 116 | 25 | 21.55
2012 | 45 | 67 | 112 | 23 | 20.54
2013 | 35 | 66 | 101 | 15 | 14.85
2014 | 24 | 56 | 80 | 12 | 15.00
2015 | 42 | 67 | 109 | 23 | 21.10
2016 | 32 | 71 | 103 | 20 | 19.42
2017 | 67 | 73 | 140 | 27 | 19.29
2018 | 43 | 85 | 128 | 26 | 20.31
2019 | 49 | 104 | 153 | 33 | 21.57
2020 | 46 | 85 | 131 | 15 | 11.45
2021 | 53 | 96 | 149 | 38 | 25.50
2022 | 48 | 80 | 128 | 22 | 17.19
2023 | 52 | 82 | 134 | 21 | 15.67
2024 | 36 | 58 | 94 | 18 | 19.15
Total | 632 | 1,112 | 1,744 | 337 | 19.32

Figure 1: Time-series analysis of amputation counts and perioperative mortality between 2010 and 2024.The graph illustrates the temporal variation in the absolute quantity (N) of amputations among male patients (blue line with squares) and female patients (pink line with circles), compared to the number of perioperative deaths (red dashed line with triangles). Additionally, the combined annual total of amputations is presented (black dotted line with diamonds) with explicit numerical values displayed for each year.

Figure 2: Annual trends in the mean age of patients undergoing major amputation.

Figure 3: Percentage of deaths per year of patients undergoing major amputation.