A Systematic Review and Narrative Synthesis of Risk Prediction Tools Used to Estimate Mortality, Morbidity, and Other Outcomes Following Major Lower Limb Amputation

ObjectiveThe decision to undertake a major lower limb amputation can be complex. This review evaluates the performance of risk prediction tools in estimating mortality, morbidity, and other outcomes following amputation.MethodsA systematic was performed Preferred Reporting Items for Systematic Reviews Meta-Analyses (PRISMA) guidelines. The MEDLINE, Embase, Cochrane databases were searched identify studies reporting on that predict amputation. Outcome measures included accuracy tool predicting range post-operative complications, including mortality (both short long term), peri-operative need re-amputation, ambulation success. A narrative synthesis accordance with Guidance Conduct Narrative Synthesis In Reviews.ResultsThe search identified 518 database records. Twelve observational studies, evaluating 13 total cohort 61 099 amputations, included. One study external validation an existing tool, while all developed novel or modified pre-existing generic calculators. Two conducted novel/modified tools. Nine provided estimations two predictions likelihood ambulation, one re-amputation same higher level. Most demonstrated acceptable discrimination C statistic values ranging from 0.65 0.81. Tools complications (0.65 – 0.74) necessity (0.72) also acceptably. Blatchford Allman Russell outstanding functional mobility post-amputation (0.94). Overall, most at high bias poor validity.ConclusionThis several demonstrate objectively array important outcomes. However, methodological quality some poor, are generally lacking, there no outcomes, especially life. Reviews. validity.