Rehabilitation of the geriatric vascular amputee patient: A population-based study

Fletcher, Dade D.; Andrews, Karen L.; Butters, Matthew A.; Jacobsen, Steven J.; Rowland, Charles M.; Hallett, John W.

doi:10.1053/apmr.2001.21856

Cited by 93 publications

(92 citation statements)

References 9 publications

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“…Data from several retrospective studies and several cohort studies in the United States [9][10][11][12][13][14] and abroad [15][16][17][18][19][20][21][22] show that the rates of prosthetic fitting vary by amputation level, with 1 yr prescription rates ranging from 49 to 93 percent for people with transtibial (TT) amputation, 14 to 57 percent for transfemoral (TF) amputation, 38 to 67 percent for knee disarticulation, and 38 to 100 percent for below-ankle amputation. However, these studies vary in their sampling frame and inclusion and exclusion criteria, and it is not possible to generalize findings to all persons who underwent major limb amputation in the United States or in the VA system.…”

Section: Introductionmentioning

confidence: 99%

Predicting prosthetic prescription after major lower-limb amputation

Resnik

Borgia

2015

J Rehabil Res Dev

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Abstract-We describe prosthetic limb prescription in the first year following lower-limb amputation and examine the relationship between amputation level, geographic region, and prosthetic prescription. We analyzed 2005 to 2010 Department of Veterans Affairs (VA) Inpatient and Medical Encounters SAS data sets, Vital Status death data, and National Prosthetic Patient Database data for 9,994 Veterans who underwent lowerlimb amputation at a VA hospital. Descriptive statistics and bivariates were examined. Cox proportional hazard models identified factors associated with prosthetic prescription. Analyses showed that amputation level was associated with prosthetic prescription. The hazard ratios (HRs) were 1.41 for ankle amputation and 0.46 for transfemoral amputation compared with transtibial amputation. HRs for geographic region were Northeast = 1.49, Upper Midwest = 1.26, and West = 1.39 compared with the South (p < 0.001). African American race, longer length of hospital stay, older age, congestive heart failure, paralysis, other neurological disease, renal failure, and admission from a nursing facility were negatively associated with prosthetic prescription. Being married was positively associated. After adjusting for patient characteristics, people with ankle amputation were most likely to be prescribed a prosthesis and people with transfemoral amputation were least likely. Geographic variation in prosthetic prescription exists in the VA and further research is needed to explain why.

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Section: Introductionmentioning

confidence: 99%

Predicting prosthetic prescription after major lower-limb amputation

Resnik

Borgia

2015

J Rehabil Res Dev

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“…Maintaining length with ray resection and digit amputation is vital as with all other amputations, however what is most important is ensuring adequate resection of the infected or ischemic digit or ulcer. A retrospective review from 2013 reports a 42.4% incidence of proximal amputation following ray resection or toe amputation [25]. Additionally, the authors report that approximately 70% of patients will return to the office with new ulcerations, wounds requiring antibiotics, or have ancillary procedures done on the operative extremity [25].…”

Section: Mid-foot and Distalmentioning

confidence: 99%

“…A retrospective review from 2013 reports a 42.4% incidence of proximal amputation following ray resection or toe amputation [25]. Additionally, the authors report that approximately 70% of patients will return to the office with new ulcerations, wounds requiring antibiotics, or have ancillary procedures done on the operative extremity [25]. Therefore, given the patient population being treated with this surgical procedure and the likelihood of proximal progression some surgeons argue a more proximal amputation may be indicated as the index and final procedure.…”

Section: Mid-foot and Distalmentioning

confidence: 99%

A Surgeon’s Perspective on Lower Extremity Amputation and Rehabilitation

Donegan¹

2017

ORP

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“…Amputation is surgery that not only requires additional funds for rehabilitation, but also prosthetic creation, management, and maintenance [19,40]. Amputation also plays a major role in an individual's psychosocial, functional, and economic status, making it more difficult for a person to return to leisure, educational, and employment activities [25,42,50,57].…”

Section: Introductionmentioning

confidence: 99%

Disparities in Amputations in Minorities

Lefebvre

Lavery

2011

Clinical Orthopaedics &Amp; Related Research

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Background As a result of the impact of health disparities on the healthcare system such as their influence on arenas significant to healthcare distribution, including cost, quality, and access, identification and resolution of health disparities is a primary national agenda item. Resolution of disparities in amputation is an area of opportunity that warrants further consideration. Questions/purposes The purposes of our review are to highlight current data on disparities in amputation in minorities and to consider future goals related to an elimination of this disparity. Methods Studies on disparities in amputation were accessed using the following databases: PubMed, Cinahl, OVID/Medline, Embase, and Cochrane databases. In each database, a search of title/abstract was performed for the search terms ''disparities and amputation,'' ''race and amputation,'' and ''diabetes and amputation.'' Each search was limited by human and English language. Where are we now? A disparity exists in both frequency and level of amputation in minorities both in the presence and absence of a diagnosis of diabetes.Where do we need to go? A need exists for future research involving a more deliberate examination of the use of preventive screening for patients at high risk for amputation across medical settings. How do we get there? Research in this area would benefit from funding, large-scale data collection, and physician exposure to education on high-risk patients and preventive screening opportunities.

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Rehabilitation of the geriatric vascular amputee patient: A population-based study

Cited by 93 publications

References 9 publications

Predicting prosthetic prescription after major lower-limb amputation

Predicting prosthetic prescription after major lower-limb amputation

A Surgeon’s Perspective on Lower Extremity Amputation and Rehabilitation

Disparities in Amputations in Minorities

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