Predictors for institutionalization and prosthetic ambulation after major lower extremity amputation during an eight-year follow-up

Aging Clinical and Experimental Research - Tập 21 - Trang 129-135 - 2013
Leena Remes1,2, Raimo Isoaho3,4,5, Tero Vahlberg6, Matti Viitanen2,7,8, Päivi Rautava1,2
1Institute of Clinical Medicine, Department of Public Health, University of Turku, Turku, Finland
2Turku City Hospital, Finland
3Institute of Clinical Medicine, Department of Family Medicine/General Practice, University of Turku, Finland
4Nordic School of Public Health, Gothenburg, Sweden
5Malax-Korsnäs Health Center, Finland
6Institute of Clinical Medicine, Department of Biostatistics, University of Turku, Finland
7Institute of Clinical Medicine, Department of Geriatrics, University of Turku, Finland
8Karolinska Institutet, Department of Geriatrics, Karolinska University Hospital, Huddinge, Stockholm, Sweden

Tóm tắt

Background and aims: Major lower extremity amputation (LEA) leads to great loss in mobility, exposing old people to the risk of losing their independent living status. This study applies predictors for institutionalization and considers prosthesis use by major lower leg amputees with peripheral arterial disease (PAD). Methods: 119 PAD patients admitted from home (mean age 73.6, SD 11.5 years, 48% men) underwent their first major LEA, 1998–2002, and survived at least one month after the operation. Logistic regression analysis was run to clarify institutionalization predictors. Prosthesis use and ambulatory capacity were recorded during the follow-up. Results: Older age, living alone, and unilateral above-knee amputation (AKA) or bilateral amputation predicted institutionalization. Of prosthesis users, 69% (27/39) were younger than 75 and 44% (17/39) were able to walk both in- and outdoors. Reasons for not receiving a prosthesis after amputation were: 1) short expected survival; 2) old age, combined with unilateral AKA or bilateral amputation; 3) unilateral AKA or bilateral amputation and a comorbid condition such as hemiparesis, paraplegia, uremia, dementia, or alcohol misuse. After one year, 72% (36/50) of amputees who were able to return home and 9% (3/32) of amputees in institutional care used a prosthesis. Conclusion: The majority of amputated patients cannot return home after their first LEA. Comorbid conditions particularly influencing functional capacity also hinder ambulation with a prosthesis.

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Thông tin xuất bản

Aging Clinical and Experimental Research

Tập 21

129-135

Thông tin tác giả