Alteração dos índices hematimétricos após amputação de membro inferior a nível supra e infra patelar em um hospital universitário: análise observacional retrospectiva

Abstract

Peripheral arterial occlusive disease (PAOD) is the term used to define chronic atherosclerotic obstruction of the arteries. PAOD may have a prevalence in the population ranging from 3.4% to 5.4%, according to data obtained in Europe. It is a condition that can lead to significant physical limitation and, in severe cases, to lower-limb amputation. Evidence shows that patients with PAOD and anemia have a higher risk of amputation, and that perioperative transfusion may add risks to the patient. In this context, this observational, retrospective, single-center study analyzed 41 patients who underwent lower-limb amputation at the supra- or infrapatellar level. Hemoglobin and hematocrit levels were measured before the procedure and up to a maximum of 72 hours after surgery, along with information related to the type of anesthesia, chronic medication use, and type of surgery. A median preoperative hemoglobin level of 9 g/dL (IQR 2.5) was observed, whereas the median postoperative hemoglobin level was 8 g/dL (IQR 2). The median preoperative hematocrit was 27.3% (IQR 6), while the median postoperative hematocrit was 24% (IQR 3.7). The use of aspirin did not increase the likelihood of hemoglobin drop after supra- or infrapatellar amputation (p = 0.863). Multiple logistic regression showed that the type of amputation (suprapatellar vs. infrapatellar) was not associated with the occurrence of a significant drop in hemoglobin (p = 0.578 and p = 0.970, respectively). These findings may help support decision-making regarding perioperative transfusion in these patients.