{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:21:22Z","timestamp":1792804882744,"version":"4.5.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T00:00:00Z","timestamp":1623801600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Major lower extremity amputation (LEA) results in significant morbidity and mortality. This study identifies factors contributing to adverse long-term outcomes after major LEA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Amputations in the Vascular Quality Initiative (VQI) long-term follow-up database from 2012 to 2017 were included. Multivariable logistic regression determined which significant patient factors were associated with 1-year mortality, long-term functional status, and progression to higher level amputation within 1\u00a0year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>3440 major LEAs were performed and a mortality rate of 19.9% was seen at 1\u00a0year. Logistic regression demonstrated that 1-year mortality was associated with post-op myocardial infarction (MI) (odds ratio (OR) 1.7, CI 1.02-2.97, P = .04), congestive heart failure (CHF) (OR 1.9, confidence interval (CI) 1.56-2.38, P &lt; .001), hypertension (HTN) (OR 1.31, CI 1.00-1.72, P = .05), chronic obstructive pulmonary disease (COPD) (OR 1.36, CI 1.13-1.63, P &lt; .001), and dependent functional status (OR 2.01, CI 1.67-2.41, P &lt; .001). A decline in ambulatory status was associated with COPD (OR 1.36, CI 1.09-1.68, P = .006). Dependent functional status was protective against revision to higher level amputation (OR .18, CI .07-.45, P &lt; .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the VQI, 1-year mortality after major LEA is nearly 20% and associated with HTN, CHF, COPD, dependent functional status, and post-op MI. Decreased functional status at 1\u00a0year was associated with COPD, and progression to higher level amputation was less likely in patients with dependent functional status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348211024639","type":"journal-article","created":{"date-parts":[[2021,6,16]],"date-time":"2021-06-16T03:52:32Z","timestamp":1623815552000},"page":"1569-1574","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Factors Affecting One-Year Outcomes After Major Lower Extremity Amputation in the Vascular Quality Initiative Amputation Registry"],"prefix":"10.1177","volume":"87","author":[{"given":"James C.","family":"Andersen","sequence":"first","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristyn A.","family":"Mannoia","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheela T.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz V.","family":"Leong","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen G.","family":"Murga","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore H.","family":"Teruya","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon C.","family":"Kiang","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Ahmed M.","family":"Abou-Zamzam","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,6,16]]},"reference":[{"key":"bibr1-00031348211024639","volume-title":"Rutherford\u2019s Vascular Surgery and Endovascular Therapy","author":"Sidawy 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