Faculty Collaboration Database

Discharge destination after dysvascular lower-limb amputations. Arch Phys Med Rehabil 2003 Nov;84(11):1662-8

Date

11/26/2003

Pubmed ID

14639567

DOI

10.1053/s0003-9993(03)00291-0

Scopus ID

2-s2.0-0242720241 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

OBJECTIVE: To examine postacute care rehabilitation services use after dysvascular amputation.

DESIGN: State-maintained hospital discharge data from the Maryland Health Services Cost Review Commission were analyzed.

SETTING: Maryland statewide hospital discharge database.

PARTICIPANTS: Persons discharged from nonfederal acute care hospitals from 1986 to 1997 with a procedure code for lower-limb amputation (ICD-9-CM code 84.12-.19), excluding toe amputations. Those persons with amputations due to trauma, bone malignancy, or congenital anomalies were excluded.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Postacute care service utilization.

RESULTS: There were 16,759 discharges with an amputation procedure over this period. The average age was 69.3+/-14.3 years, and 51.9% were men. Black persons comprised 42.4% of the sample. Diabetes was present in 42.0%, and peripheral vascular disease was noted for 66.1% of amputees. Amputations were at the foot (19.4%), transtibial (38.1%), and transfemoral (42.4%) levels. The largest proportion (40.6%) of patients was discharged directly home after acute care, 37.4% went to a nursing home, 9.2% went home with home care, and 9.6% were discharged to an inpatient rehabilitation unit. From 1986 to 1997, there were downward trends in the rate of discharges directly home and corresponding upward trends in nursing home and inpatient rehabilitation dispositions.

CONCLUSIONS: Inpatient rehabilitation use is infrequent after dysvascular amputation. Prospective studies are necessary to examine outcomes for persons receiving rehabilitation services in different care settings to define the optimal rehabilitation venue for functional restoration.

Author List

Dillingham TR, Pezzin LE, Mackenzie EJ

Author

Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Artificial Limbs
Female
Humans
Insurance, Health
Leg
Male
Maryland
Middle Aged
Patient Discharge
Peripheral Vascular Diseases
Rehabilitation Centers