PMID- 22686166
OWN - NLM
STAT- MEDLINE
DCOM- 20140310
LR  - 20221207
IS  - 1464-5165 (Electronic)
IS  - 0963-8288 (Linking)
VI  - 35
IP  - 3
DP  - 2013 Feb
TI  - Rehabilitation outcome of post-acute lower limb geriatric amputees.
PG  - 221-7
LID - 10.3109/09638288.2012.690818 [doi]
AB  - PURPOSE: To characterize the lower-limb elderly amputee patients admitted to a 
      post-acute rehabilitation program, assess their 1-year survival rate, estimate 
      rate of prosthetic fit and report rate and factors associated with 1-year 
      post-discharge prosthetic use. METHODS: A cohort study performed in a post-acute 
      rehabilitation department. Patients were evaluated by the Functional Independence 
      Measure (FIM), motor FIM (mFIM), rate of prosthesis fit, length of stay (LOS), 
      1-year survival rate and long-term prosthetic use. RESULTS: One-hundred and 
      seventeen lower limb elderly amputee patients consecutively admitted from January 
      2004 to June 2010 were enrolled in the study. Mean age was 74.7 +/- 8.1; 56 
      patients (47.9%) had transtibial amputation (TTA); 46 (39.3%) transfemoral 
      amputation (TFA) and 15 (12.8%) bilateral amputation. The main cause for 
      amputation was diabetic foot (60.7%). Fifty-four (46.2%) patients died during 
      first year post-admission. Twenty-seven patients (23.1%) were fitted with a 
      prosthesis. When the bilateral amputees were considered separately, the rate of 
      prosthetic fit among unilateral amputees was 24.5% (25/102) whereas among 
      bilateral amputees it was 20% (3/15). Patients with prosthesis rehabilitation had 
      a higher rate of TTA (p = 0.027), better metabolic status (p < 0.001), higher 
      functional and cognitive levels (p < 0.001), and longer LOS (p < 0.001) compared 
      with patients who received wheelchair rehabilitation. Twenty patients were 
      contacted 1 year later: eight (40.0%) reported continuous functional prosthesis 
      use, eight - partial prosthesis use and four (20%) did not use the prosthesis at 
      all. The patient group with 1-year post-discharge prosthesis use had a 
      significantly higher rate of TTA (p = 0.032), lower rate of congestive heart 
      failure (CHF) (p = 0.014) and higher score changes on the FIM and mFIM (p = 
      0.043). CONCLUSIONS: Rehabilitation efforts should best be targeted depending on 
      need. Rehabilitation professionals should make an educated estimate of outcomes 
      at the beginning of rehabilitation based on the characteristics of the patients 
      (level of amputation and functional level on admission).
FAU - Hershkovitz, Avital
AU  - Hershkovitz A
AD  - Geriatric Rehabilitation Ward, Beit Rivka Geriatric Rehabilitation Center, Petach 
      Tikva, Israel. avitalhe@clalit.org.il
FAU - Dudkiewicz, Israel
AU  - Dudkiewicz I
FAU - Brill, Shai
AU  - Brill S
LA  - eng
PT  - Journal Article
DEP - 20120611
PL  - England
TA  - Disabil Rehabil
JT  - Disability and rehabilitation
JID - 9207179
SB  - IM
MH  - Aged
MH  - Amputation, Surgical/mortality/*rehabilitation
MH  - Amputees/*rehabilitation
MH  - Artificial Limbs/psychology
MH  - Cohort Studies
MH  - Diabetic Foot/mortality
MH  - Geriatric Assessment
MH  - Humans
MH  - Length of Stay
MH  - Logistic Models
MH  - Lower Extremity/*surgery
MH  - Recovery of Function
MH  - Socioeconomic Factors
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2012/06/13 06:00
MHDA- 2013/08/24 06:00
CRDT- 2012/06/13 06:00
PHST- 2012/06/13 06:00 [entrez]
PHST- 2012/06/13 06:00 [pubmed]
PHST- 2013/08/24 06:00 [medline]
AID - 10.3109/09638288.2012.690818 [doi]
PST - ppublish
SO  - Disabil Rehabil. 2013 Feb;35(3):221-7. doi: 10.3109/09638288.2012.690818. Epub 
      2012 Jun 11.