Publication date: Mar 21, 2025

Amputation is an undesirable outcome of severe peripheral artery disease (PAD) which affects both the mobility and broader lifestyle of the patient. Prior studies have shown that lower extremity amputation is associated with increased risk of developing depression in the postoperative period. However, these studies are primarily single center, confined to specific populations, or do not include analysis over various timepoints. The objective of this study was to assess the association between lower extremity amputation level, level of amputation, and postoperative development of depression. This information will allow vascular surgeons to identify patients who are at a high risk for the development of depression after amputation and make the necessary psychiatric referrals. 48,568 adult patients who underwent PAD-related lower extremity amputation were identified from the TriNetX Research database following exclusion of those with preoperative depression or use of antidepressants. Propensity score matching was used to develop comparable major amputation (Above- and Below-Knee Amputations) (I) and minor amputation cohorts (Toe and foot amputations) (II), yielding two groups each with 14,853 patients. Primary outcomes included postoperative diagnosis of major depressive disorder (MDD), prescription of antidepressants, and mortality. Outcomes were analyzed at 6-month and 1-year timepoints. Analysis at 6 months demonstrated that major amputation was associated with a higher risk of developing MDD (6. 3% vs 4. 6%, p-value

Semantics

Original Article