Hemodynamic Alterations After Traumatic Amputation in the Immediate Postoperative Period

创伤性截肢术后即刻血流动力学改变

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Abstract

Background Although long-term outcomes and chronic cardiovascular changes following amputation have been studied, there is limited literature on the acute hemodynamic alterations that occur in the immediate postoperative period of patients suffering from a traumatic amputation. Currently, no standardized management algorithms exist to guide care during this critical phase. This retrospective observational study aims to identify factors associated with cardiovascular changes and the relationship to morbidity and mortality in patients with traumatic amputations.  Objective To evaluate acute cardiovascular effects and related clinical markers in patients undergoing traumatic amputations.  Methods A retrospective observational study was conducted using data from the Northeast Georgia Health System Trauma Registry, a Level I community trauma center. Patients who sustained a traumatic amputation between January 2019 and September 2024 were included. Results A total of 34 patients met the inclusion criteria. Although the small sample size limited statistical power, several notable trends were observed. Patients who underwent above-knee amputation (AKA) were more likely to require continuous renal replacement therapy (CRRT) and received higher volumes of blood products compared to those with below-knee amputations (BKA). Additionally, patients who died had higher injury severity score (ISS) than survivors.  Conclusion While no definitive clinical recommendations could be established due to the limited sample size, the findings highlight key trends that merit further investigation. Future studies at high-volume centers or through multicenter collaborations may better elucidate the acute cardiovascular impacts of traumatic amputation and support the development of targeted management strategies.

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