The Scope of Non-Trauma Lower Limb Amputations at the Komfo Anokye Teaching Hospital, Kumasi-Ghana
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Date
2015-11-19
Journal Title
Journal ISSN
Volume Title
Publisher
MedCrave
Abstract
Background: Lower limb amputation has a significant impact on the quality of
life of the affected individual and family. Non-trauma amputations are the result
of neglected public health conditions like complications of Diabetes mellitus,
peripheral arterial disease and malignancies. The incidence of non-trauma
amputation is increasing in Ghana mainly due to these non-communicable
diseases which can be ascribed partially to changing lifestyles.
Objective: The objective of this study is to determine the demographic profile
of non-trauma amputees, indications and patterns of amputation, duration of
symptoms before reporting to hospital, reasons for delay in seeking medical care,
and length of hospital stay from admission to discharge.
Methods: A prospective cross sectional study was carried out at the General
Surgery Unit of the Komfo Anokye Teaching Hospital from November 2012
to October 2014. All patients on admission who had undergone lower limb
amputation for non-trauma indications were interviewed using structured
questionnaire. Their clinical notes were used to collect extra information on
clinical management data to satisfy the set objectives. Data was analyzed with
Epi Info version 3.5.1. Results were presented using simple descriptive statistics.
Ethical clearance was obtained from CHRPE.
Results: A total of 104 patients underwent amputation for non-trauma
indications during the period under study. The mean age of respondents was
65years ± 14.7 SD with a Male: Female ratio of 1.6:1. Majority; 85 (81.7%) had
either no formal education or only primary education while 71 (68.3%) were
employed in the informal sector (mainly farmers, artisans and traders). Twentythree (22.1%) were unemployed and 1 (0.9%) was a student. The indications
for non-trauma amputations were diabetic leg ulcers; 55 (52.9%), peripheral
arterial disease; 42 (40.4%), malignancies; 6 (5.7%), and post-burn contracture;
1 (0.9%). The pattern of amputation were above knee amputation; 64 (61.5%),
below knee amputation; 23 (22.1%), Rays amputation of the toe; 15 (14.4%) and
2 (1.9%) Hip de-articulation. Sixteen (15.4%) presented within 3 months of onset
of symptoms, while 57 (54.8%) presented between 3-6 months and 31 (29.8.0%)
after 6 months. Reasons for delayed presentation were: home treatment with
herbs; 43 (41.3 %), fear of having limbs amputated; 25 (24.0%), financial
constraints; 16 (15.4%), lack of nearby health facilities; 5 (5.4) % and others. The
duration of hospital stay was from 4 - 86 days with a mean of 17.53 ±14.83SD.
Conclusion and Recommendation: This study concluded that complications of
diabetes mellitus were the major indication for non-trauma amputations in KATH.
Above knee amputation was the commonest pattern of amputation. Majority of
patients presented between 3-6 months of onset of symptoms. Commonest reason
for delayed presentation to hospital was the preference of herbal medications to
hospital treatment. Duration of hospital stay from admission to discharge was
approximately 5 weeks. It is recommended from evidence gathered from this
study that proper attention should be given to improving the awareness and
quality of care of diabetes mellitus to minimize its complications leading to nontrauma amputations.
Description
Published in MOJ Orthopedics & Rheumatology.Volume 3 Issue 5 - 2015
Keywords
Non-trauma, Amputation, Diabetes Mellitus, Lower Limb, Ghana
Citation
Publish in MOJ Orthopedics & Rheumatology. Volume 3 Issue 5 - 2015