# A Novel Scoring System for Predicting Mortality, Morbidity, and Functional Outcomes in Patients Following Below-Knee Amputation: A Retrospective Study

## TL;DR

A new scoring system was developed to predict outcomes like mortality and functional independence in patients after below-knee amputation, but it needs more validation.

## Contribution

A novel scoring system was developed to predict mortality, morbidity, and functional outcomes after below-knee amputation.

## Key findings

- Higher scores in the new index were significantly associated with increased mortality and morbidity (p<0.05).
- There was a strong negative correlation between risk scores and Katz scores (r=-0.757; p<0.001), indicating worse functional outcomes with higher risk scores.

## Abstract

Objective

Patients undergoing below-knee amputation may experience considerable postoperative mortality risk, particularly in the presence of comorbid conditions. The aim of this study was to present a newly developed risk index and scoring system to predict one-year mortality, morbidity, and functional independence in patients undergoing below-knee amputation.

Materials and methods

One-year postoperative follow-up data were obtained retrospectively from 30 patients who underwent below-knee amputation at our clinic. A novel scoring system was developed using variables including age, preoperative systemic diseases, diabetic foot infection, previous extremity surgery, postoperative mobilization time, and early complications. Survival analysis was performed, and functional independence was assessed using the Katz Activities of Daily Living Scale (Katz scores). The relationship between patients' survival status and Katz scores with the developed risk index was statistically evaluated.

Results

The average age of the patients was 71.7 years. Survival analysis indicated that higher scores on the newly developed index were significantly associated with increased mortality and morbidity (p<0.05). There was also a strong negative correlation between patients' scores and Katz scores (r=-0.757; p<0.001), indicating that patients with higher risk scores experienced poorer functional outcomes.

Conclusions

This retrospective study introduced a novel scoring system that reliably predicts functional independence in patients following below-knee amputation. However, its accuracy in predicting mortality and morbidity remains limited. Further refinement and validation in larger patient populations are required to enhance predictive accuracy and clinical applicability.