Patterns and indications of amputation among patientsin Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia: a three-year retrospective study

Abstract

Amputation is the removal of whole or part of a limb, often as a life saving measure. Major limb amputation is reported to be a major preventable public health problem that is associated with profound economic, social and psychological effects on the patient and. Knowledge on the leading causesof amputation and common underlying indications are scarce in Ethiopia. The aim of this study was to assess patterns and indications of amputations among patients operatedbetween September 11, 2016 and September 11, 2019 inHiwot Fana Specialized University Hospital, Harar, Ethiopia. Methods: Facility based retrospective cross-sectional study design was used to review amputations from the overall major operations performed during the study period. Patients’ charts were retrieved from card room by using medical record number registered on operation logbook in operation theatre and admission register in the surgical ward.Data from patient’s charts wasretrieved by trained nurses/interns using check list prepared for this purpose. Information about the sociodemographic conditions, amputation patterns and indications, and outcome at discharge were collected. The data were entered using EpiData 3.1 and analyzed using SPSS 20.0. Descriptive statistics was applied to determine means, frequencies and range. Results: Of 3433 major operations performed during the study period, a total of 110(3.2%) were amputations. Majority of the cases were males (73.6%), younger than 46 years of age(63.6%), lower limb amputations (77.2%), and above knee amputations (47.3%). The leading cause of amputation was PAD (38.2%) followed by trauma (28.2%), and idiopathic gangrene (18.2%). Major amputation accounts for 87.3% of all cases. Conclusions:More than three in hundred operations in the hospitals during the study period were amputations. The majority of amputees were younger adults and major amputations were common. Most of cases presented late with advanced stage when limb sparing was not a viable option. Early identificationof risk factors for PAD and health education for supporting early health care seeking is required for minimizing late presentation