SP4.02 Retrospective Analysis of Risk Factors for Loss to Follow-Up After Major Lower Limb Amputation

Aim To gain a deeper understanding of the factors contributing to loss to follow-up (FU) after major lower limb amputation (MLLA) and their impact on the quality of care. Method A retrospective analysis was performed from 2019 to 2024, focusing on vascular patients who underwent MLLA. The collected data encompassed patient demographics, comorbidities, the number of MLLA procedures, postoperative complications, and instances of loss to follow-up. The primary outcomes included the rate and reason of loss to FU. The chi-square analysis was used for bivariate analysis, while the Welch t-test for univariate analysis. Results 512 patients underwent MLLA, with 380 (74%) male. Most patients (328, 64%) were between 60 and 79. Obesity was observed in 144 patients (28%) and a history of smoking in 433 (85%). 383 patients (74%) were multimorbid, with the most common being a history of peripheral vascular disease (352, 68%) and diabetes (292, 56%), including severely uncontrolled diabetes in 110 patients. Below-knee amputations were performed in 267 patients (52%), while above-knee amputations in 240 (46%) patients. 35 (7%) passed away. 101 patients (20%) were lost to FU, including 89 failing to attend clinics and 10 relocated outside the catchment area. Age, being single, smoking and higher ASA grade were significantly associated with loss to FU (p-value <0.05, CI of 95%). Conclusion Loss to FU among patients after MLLA represents a significant challenge. Proactively identifying and addressing risk factors is crucial to enhancing long-term care quality and mitigating the psychological burden experienced by this patient population.