The effect of amputation level on patient mental and psychological health, prospective observational cohort study. (December 2022)

• Record Type: Journal Article
• Authors: Abdel Rahim, A.; Tam, A.; Holmes, M.; Mittapalli, D.
• Is Part Of: Annals of medicine and surgery. Volume 84(2022)
• Publication Date: 2022-12
• Subjects: Non-traumatic amputations -- Trans-tibial amputations -- Tans-femoral amputation -- Hospital anxiety and depression score for anxiety (HADS-A) -- Hospital anxiety and depression score for depression (HADS-D) -- Mental and psychological health; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2022.104864
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background: Non-traumatic lower limb amputation is a commonly performed surgical procedure and is associated with a high prevalence of psychological morbidity including anxiety and depression. Many risk factors have been identified, including the indication for amputation, perioperative pain and sociodemographic factors. Objective: The aim of this study was to identify whether level of amputation has an impact on this psychological morbidity. Methods: A prospective observational study was conducted in a tertiary vascular unit including all adult non-traumatic amputations performed during a 6 month period. The Hospital Anxiety and Depression Scale (HADS) was used to score anxiety and depression pre and postoperatively. Results: 49 patients met the inclusion criteria (22 trans-femoral amputations (AKA) and 27 trans-tibial amputations (BKA)). HADS scores for anxiety and depression were high in both groups both pre and postoperatively. A higher level of anxiety was noted in the BKA group, significantly decreasing postoperatively (p < 0.05). No other statistically significant differences were found between the two groups. Conclusion: In non-traumatic amputations, there appears to be a higher rate of pre-operative anxiety in patients undergoing trans-tibial amputation compared with trans-femoral amputees. However, the level of amputation does not appear to have a significant effect on psychological status of patients with high rates of depression and anxiety demonstrated in both groups. Highlights: Part of the rehabilitation process of the non-traumatic amputee is their mental and psychological health. In non-traumatic amputations, there appears to be a higher rate of pre-operative anxiety in patients undergoing trans-tibial amputation compared with trans-femoral amputees. The level of amputation does not appear to have a significant effect on psychological status of patients. The cohort showed high rates of preoperative anxiety and postoperative depression.