Amputations in Sepsis Patients: A Population‐Based Cohort Study of Rates and Risk Factors
- 1Centre for Health Systems and Safety Research Australian Institute of Health Innovation, Macquarie University Sydney Australia
Abstract
Background: A rare and serious adverse outcome of sepsis is surgical amputation. Limited research has examined the prevalence and risk factors associated with amputations among sepsis patients.
Aims: To (i) assess the rate of sepsis‐related amputations in hospitals and (ii) identify associated risk factors.
Methods: A retrospective cohort study of sepsis patients admitted to any hospital in New South Wales, Australia, from 1 January 2015, to 31 January 2021. The primary outcome was the rate of amputations in sepsis patients. The secondary outcome was amputation risk factors, identified using multivariable logistic regression.
Results: There were 158 842 sepsis patients hospitalised during the study period. The amputation rate was 1.11% (1637/148061) in non‐maternal adult patients, 0% (0/3656) in maternal sepsis patients, and < 0.15% (< 10/7125) in paediatric patients. In adult patients with septic shock (n = 20 354), 283 (1.39%) had an amputation. After adjustment for sex, age group, socioeconomic status, geographical remoteness, diabetes and peripheral arterial disease (PAD), factors associated with a higher odds of amputation in adult patients (n = 148 061) were being male (adjusted Odds Ratio [aOR] 2.16, 95% CI: 1.93–2.43; p < 0.001), having diabetes (aOR 9.06, 95% CI: 8.01–10.23; p < 0.001) or having PAD (aOR 19.29, 95% CI: 17.01–21.88; p < 0.001). Compared to patients aged ≥ 85 years, those 16 to 59 years (aOR 3.65, 95% CI: 3.00–4.44; p < 0.001) and 60 to 84 years (aOR 2.19, 95% CI: 1.83–2.63; p < 0.001) also had higher odds of amputation.
Conclusions: This large population study provides much‐needed evidence on the burden and risk factors of amputations in sepsis patients.
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BibTeX
@article{ackermann2026amputations,
title = {{Amputations in Sepsis Patients: A Population‐Based Cohort Study of Rates and Risk Factors}},
author = {Khalia Ackermann and Nanda Aryal and Johanna Westbrook and Ling Li},
journal = {Anz Journal of Surgery},
year = {2026},
month = jul,
doi = {10.1111/ans.70835},
url = {https://doi.org/10.1111/ans.70835},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Amputations in Sepsis Patients: A Population‐Based Cohort Study of Rates and Risk Factors
AU - Khalia Ackermann
AU - Nanda Aryal
AU - Johanna Westbrook
AU - Ling Li
PY - 2026
DA - 2026/07/01
JO - Anz Journal of Surgery
DO - 10.1111/ans.70835
UR - https://doi.org/10.1111/ans.70835
AB - Background: A rare and serious adverse outcome of sepsis is surgical amputation. Limited research has examined the prevalence and risk factors associated with amputations among sepsis patients. Aims: To (i) assess the rate of sepsis‐related amputations in hospitals and (ii) identify associated risk factors. Methods: A retrospective cohort study of sepsis patients admitted to any hospital in New South Wales, Australia, from 1 January 2015, to 31 January 2021. The primary outcome was the rate of amputations in sepsis patients. The secondary outcome was amputation risk factors, identified using multivariable logistic regression. Results: There were 158 842 sepsis patients hospitalised during the study period. The amputation rate was 1.11% (1637/148061) in non‐maternal adult patients, 0% (0/3656) in maternal sepsis patients, and < 0.15% (< 10/7125) in paediatric patients. In adult patients with septic shock (n = 20 354), 283 (1.39%) had an amputation. After adjustment for sex, age group, socioeconomic status, geographical remoteness, diabetes and peripheral arterial disease (PAD), factors associated with a higher odds of amputation in adult patients (n = 148 061) were being male (adjusted Odds Ratio [aOR] 2.16, 95% CI: 1.93–2.43; p < 0.001), having diabetes (aOR 9.06, 95% CI: 8.01–10.23; p < 0.001) or having PAD (aOR 19.29, 95% CI: 17.01–21.88; p < 0.001). Compared to patients aged ≥ 85 years, those 16 to 59 years (aOR 3.65, 95% CI: 3.00–4.44; p < 0.001) and 60 to 84 years (aOR 2.19, 95% CI: 1.83–2.63; p < 0.001) also had higher odds of amputation. Conclusions: This large population study provides much‐needed evidence on the burden and risk factors of amputations in sepsis patients.
SN - 1445-1433
SN - 1445-2197
ER -