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The following is a summary of “Post–below-knee amputation venous thromboembolism and mortality in United States veterans,” published in the May 2025 issue of Research and Practice in Thrombosis and Haemostasis by Nguyen et al. 

Patients undergoing below-knee surgical amputation (BKA) were at risk of postoperative venous thromboembolism (VTE), including venous thrombosis, but prior studies had limitedly quantified the rate of VTE post-BKA or its association with survival in this population.  

Researchers conducted a retrospective study to examine the incidence of VTE among Veterans who underwent BKA and its association with all-cause mortality in the United States. 

They included veterans who underwent surgical BKA between October 2016 and January 2023. The VTE within 90 days post-amputation was identified using a validated algorithm that combined International Classification of Diseases codes with new anticoagulant prescriptions, inferior vena cava filter placement, or death within 30 days. A time-dependent Cox proportional hazards model assessed the association between VTE and mortality, adjusting for potential confounders. A sensitivity analysis excluded individuals with acute VTE defined by the International Classification of Diseases codes plus death within 30 days.  

The results showed that 6,305 individuals underwent a first-time surgical BKA, and 132 developed VTE within 90 days following the procedure. A younger age was linked to a lower likelihood of post-BKA VTE. After adjusting for potential confounding variables, the presence of VTE within 90 days post-BKA was associated with a 3-fold increase in mortality risk (adjusted hazard ratio, 3.17; 95% CI, 2.12–4.17).  

Investigators concluded that patients who experienced a VTE within 90 days following BKA showed a higher mortality rate compared to those without VTE post-BKA. 

Source: rpthjournal.org/article/S2475-0379(25)00179-7/fulltext