In an open-access study published September 5 in the Journal of NeuroEngineering and Rehabilitation, researchers examined the association between transfemoral (above-knee) amputation and the risk of experiencing a major cardiac event for those who had either dysvascular or traumatic amputations. The study concluded that cardiac events appear to be more likely among patients with dysvascular transfemoral amputations. The association of receiving a prosthesis with the risk of experiencing a major cardiac event was also examined, and the researchers found that providing a prosthesis did not appear to be associated with a reduced risk of a major cardiac event.
The study population included all individuals with a transfemoral amputation or knee disarticulation (n = 162) who resided in Olmsted County, Minnesota, between 1987 and 2014. Each was matched at a 1:10 ratio with able-bodied adults in age, sex, and duration of residency.
The research team conducted a competing risk Cox proportional hazard model to estimate the relative likelihood of an individual with a transfemoral amputation experiencing a major cardiac event in a given time period as compared to the matched controls. The cohort was divided by amputation etiology of dysvascular versus trauma/cancer. Additional analysis was performed by combining all individuals with a transfemoral amputation to look at the relationship between prosthesis receipt and major cardiac events.
The results indicated that individuals with a dysvascular transfemoral amputation had an approximately four-fold increased risk of a cardiac event after undergoing an amputation. These individuals also had an increased risk for non-cardiac mortality. The risk of a cardiac event was no higher for those with a trauma/cancer-related transfemoral amputation relative to the able-bodied controls. Finally, there was no difference in risk of experiencing a cardiac event for those with or without prosthesis, according to the study.
