Retrospective analysis of mortality and quality of life after hip disarticulation or hemipelvectomy: a report on 15 patients

Schindler, Melanie and Baertl, Susanne and Walter, Nike and Lang, Siegmund and Szymski, Dominik and Alt, Volker and Rupp, Markus (2023) Retrospective analysis of mortality and quality of life after hip disarticulation or hemipelvectomy: a report on 15 patients. ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY, 143. pp. 4943-4949. ISSN 0936-8051, 1434-3916

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Abstract

BackgroundHip disarticulation and hemipelvectomy are defined as major ablative amputations of the lower limb. Due to the small number of patients, little is known about the outcome and follow-up.AimsWe aimed to assess (1) reasons for performed major ablative surgeries such as hip disarticulation and hemipelvectomy in a German center for trauma and orthopedic surgery. (2) In addition, mortality and quality of life after hip disarticulation and hemipelvectomy as well as (3) patient and treatment characteristics should be investigated.MethodsDuring a period of twelve years, 15 patients underwent hip disarticulation or hemipelvectomy. Mortality, EQ-5D-3L quality of life by EQ-5D-3L and time-trade-off (TTO), VAS, cause of disarticulation, length of hospital stays, revisions, comorbidities, Charlson comorbidity index (CCI), and ASA score were evaluated retrospective for all patients.ResultsThe overall mortality rates were 26.7% at 30 days, 60.0% after one year and 66.7% after three years. The five surviving patients reported about moderate problems in the EQ-5D-3L. The average VAS score reached 45 (range 15-65). The mean TTO was 9.8 (range 6-12). Indications for amputation were infection (n = 7), tumor (n = 6), trauma (n = 1) and ischemia (n = 1).ConclusionHip disarticulation and hemipelvectomy are followed by a high postoperative mortality. Quality of life of the affected patients is impaired in long-term follow-up. Especially amputations performed due to infections show high mortality within one month after surgery despite average young age and low CCI. Surgeons should be aware of this devastating outcome and extraordinary vigilant for these vulnerable patient cohorts.

Item Type: Article
Uncontrolled Keywords: AMPUTATION; LIMB; Hip disarticulation; Hemipelvectomy; Amputation; Infection; Tumor; Survival
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Unfallchirurgie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 13 Mar 2024 09:28
Last Modified: 13 Mar 2024 09:28
URI: https://pred.uni-regensburg.de/id/eprint/59472

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