{
  "abstract": "Introduction\n\nMortality after major lower limb amputation is a key factor in the decision to perform surgery. This review synthesizes the evidence on in-hospital and 30-day postoperative mortality after major amputation.Methods\n\nElectronic databases Medline, Embase, Scopus and African Journals Online were searched using keywords and thesaurus terms in October 2024 and updated in November 2025. Studies published globally and reporting in-hospital or 30-day mortality after major lower limb amputation (defined as at- or above-ankle amputation, or transtibial amputation (TTA) and/or transfemoral amputation (TFA)) and published between 2008 and 2025 were included. Only population level studies were included. Meta-analysis was performed and prediction intervals used to report findings primarily. The Newcastle-Ottawa tool was used to assess the methodological quality of studies.Results\n\nFifty-two studies were included (1 067 616 patients). Only three studies were from low- and middle-income countries (two from Brazil, one from Togo). Most studies were either from North America (42%) or Europe and Central Asia (36%). Twenty-six studies reported in-hospital mortality and 26 reported 30-day mortality. Prediction intervals were 3.6-24.5% (point estimate 10.0%, 95% confidence interval 8.2% to 12.1%; 664 608), and 4.0-20.4% (point estimate 9.4%, 8.0% to 11.0%; 390 030) for in-hospital and 30-day mortality, respectively. In-hospital mortality prediction intervals were 2.9-12.7% (point estimate 6.2%, 5.1% to 7.7%; 77 204) for TTAs and 5.6-23.3% (point estimate: 11.8%, 9.6% to 14.4%; 78 632) for TFAs. Prediction intervals for 30-day mortality were 2.5-11.6% (point estimate 5.5%, 4.5% to 6.7%; 87 971) for TTAs and 4-26.6% (point estimate 10.9%, 8.3% to 14.2%; 42 145) for TFAs. Heterogeneity was high (> 75%) across all analyses.Conclusion\n\nMost studies reporting short-term outcomes after major lower limb amputation are from high-income countries. Reported mortality is highly variable, but prediction intervals can be used to estimate mortality in future studies and inform shared decision-making.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Applied Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK.",
    "Gwent Vascular Institute, Royal Gwent Hospital, South East Wales Vascular Network, Newport, Wales, UK.",
    "Department of Vascular Surgery, Imperial College NHS Trust, London, UK.",
    "Department of General Surgery, Lewisham and Greenwich NHS Trust, London, UK.",
    "Department of Vascular Surgery, Guy's and St Thomas' NHS Trust, London, UK.",
    "Faculty of Life Sciences and Medicine, King's College London, London, UK.",
    "South East Wales Vascular Network, University Hospital of Wales, Cardiff, Wales.",
    "Division of Population Medicine, Cardiff University, Cardiff, UK.",
    "Centre for Global Surgery, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Nick Moody"
    },
    {
      "affs": [
        1
      ],
      "name": "Rhiannon Nielsen"
    },
    {
      "affs": [
        2
      ],
      "name": "Megan Lyons"
    },
    {
      "affs": [
        3
      ],
      "name": "Leanne Murphy"
    },
    {
      "affs": [
        4,
        5
      ],
      "name": "Becky Sandford"
    },
    {
      "affs": [
        6,
        7
      ],
      "name": "David C Bosanquet"
    },
    {
      "affs": [
        8
      ],
      "name": "Kathryn Chu"
    },
    {
      "affs": [
        0
      ],
      "name": "Matthew Popplewell",
      "orcid": "0000-0002-6239-4039"
    },
    {
      "affs": [
        0
      ],
      "name": "Justine Davies"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/27tbynkdbh9t1.bib",
  "cited_by": 0,
  "doi": "10.1093/bjsopen/zrag122",
  "fulltext_url": "https://europepmc.org/articles/PMC13692688",
  "id": "27tbynkdbh9t1",
  "issns": [
    "2474-9842"
  ],
  "landing_url": "https://europepmc.org/article/MED/42925092",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2712|Diabetic Foot Ulcer Assessment and Management"
    ]
  ],
  "openalex": "W7223305405",
  "pdf_url": "https://europepmc.org/articles/PMC13692688?pdf=render",
  "pmcid": "PMC13692688",
  "pmid": "42925092",
  "published": "2026-09-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/27tbynkdbh9t1.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:02Z",
      "native_id": "MED:42925092",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42925092"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Diabetic Foot Ulcer Assessment and Management",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Short-term outcomes after major lower limb amputation: meta-analysis.",
  "title_text": "Short-term outcomes after major lower limb amputation: meta-analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:02Z",
  "url": "https://research.draconitic.com/paper/27tbynkdbh9t1",
  "venue": "BJS open",
  "versions": []
}