PATTERNS AND DETERMINANTS OF LIMB AMPUTATIONS IN A SECONDARY-LEVEL HOSPITAL IN MEXICO: A POST-COVID ANALYSIS. leonardoglz.bs@gmail.com

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PATTERNS AND DETERMINANTS OF LIMB AMPUTATIONS IN A SECONDARY-LEVEL HOSPITAL IN MEXICO: A POST-COVID ANALYSIS.

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Mexico

Poster Exhibition only

Diabetes mellitus remains the leading global cause of limb amputations due to progressive peripheral microangiopathy. In Mexico, 47–53% of amputations are infracondylar and 31–33% supracondylar. Following the COVID-19 pandemic, increases in both the frequency and severity of amputations have been observed.

Retrospective, cross-sectional study at Hospital General de Zona No. 50 (IMSS) from December 2021 to December 2024. All surgical records involving upper or lower limb amputations were reviewed. Variables included age, etiology, level of amputation, and survival outcome.

Of 169 total cases, 149 met inclusion criteria. The mean age was 58.8 years (SD: 14.7; range: 17–92; variance: 217.1). Age peaks occurred in the 55–59 (n=25) and 70–74 (n=18) groups. Main causes were diabetes mellitus (41.6%), arterial insufficiency (12.8%), trauma (8.1%), and cancer (3.4%). Amputations were supracondylar (37%), toe-level (30.2%), and infracondylar (9%). Four disarticulations occurred, all due to severe diabetic foot; three of these patients died within 72 hours. Survival outcomes included 134 live discharges, 7 postoperative deaths, 1 intraoperative death, and 7 reinfections. Cancer patients had the highest mortality (20%). A post-COVID peak was recorded from January–May 2022 (9 amputations/month), followed by a significant decline in 2023 (1–3/month). An unexpected rise in oncologic and critical vascular cases signaled a shift in amputation patterns.

The post-pandemic period revealed increased amputation severity, delayed presentation, and broader etiologic profiles. These trends underscore the need for improved diabetic foot management and timely vascular intervention strategies in secondary-level hospitals.