Journal of Clinical Medicine
Chronic Pain and Residual Limb Outcomes Following Primary Major Lower Extremity Amputation vs. Minor-to-Major Amputation Progression: A Propensity Score-Matched Analysis
By Matthew D. Ramsey, Jason Zhang, Sophia Bonfigli and 3 others.
Abstract
Introduction
It is unclear if the pathway to major lower-extremity amputation (LEA) impacts development of post-amputation pain. This study compares pain outcomes between patients with minor LEA progressing to major amputation versus primary major LEA.
Methods
Adults with major LEA (proximal to the ankle) were identified from the TriNetX Global Collaborative Network (2010–2026). Patients with an initial minor LEA (distal to the ankle) followed by a subsequent, distinct major LEA were compared with patients undergoing primary major LEA via propensity score matching across a total of 99 covariates. Patients with progression were further stratified using six intervals (0–3, 3–6, and 6–12 months, and ≥1, ≥2, and ≥5 years) corresponding to time between amputations. Outcomes were assessed using two-proportion z-tests and Kaplan–Meier time-to-event analysis.