Prosthesis use and satisfaction among persons with dysvascular lower limb amputations across postacute care discharge settings. PM R 2014 Dec;6(12):1128-36
Date
06/24/2014Pubmed ID
24953447DOI
10.1016/j.pmrj.2014.05.024Scopus ID
2-s2.0-84916883714 (requires institutional sign-in at Scopus site) 19 CitationsAbstract
OBJECTIVE: To test the hypotheses that patients undergoing major lower limb amputations who received postacute care at an inpatient rehabilitation facility (IRF) would experience higher prosthesis use and satisfaction and lower prosthesis-related adverse effects than those treated at a skilled nursing facility (SNF) or at home.
DESIGN: Population-based, observational, prospective, multicenter study.
SETTING: Hospitals and communities in 2 racially and geographically diverse states.
PARTICIPANTS: Patients 21 years and older who were identified during the surgical acute care stay as undergoing major lower limb amputations.
MAIN OUTCOME MEASURES: Prosthesis use; satisfaction with prosthesis' comfort, appearance, and gait; and the presence of skin irritation, pain, and wounds as a result of prosthesis use.
METHODS: Two-stage instrumental variable models applied to data collected from medical records and patient interviews.
RESULTS: Only 149 (50.2%) of the 297 study participants had a prosthesis at the 6-month follow-up. Regression-adjusted outcomes indicate that patients treated at IRFs used their prosthesis more hours per week (52.8 versus 36.2 h/wk or 46% higher use), were less likely to experience prosthesis-related pain (16% versus 33.7%) and were significantly more likely to be satisfied with their gait (76.1% versus 59.3%) than were patients treated at SNFs. No significant differences in outcomes were found between patients who received care at an IRF and patients who were discharged home.
CONCLUSIONS: These results add to the growing body of literature suggesting a general pattern of better outcomes for persons with vascular-related amputations who receive postacute care at IRFs relative to SNFs.
Author List
Roth EV, Pezzin LE, McGinley EL, Dillingham TRAuthors
Emily L. McGinley Biostatistician III in the Center for Advancing Population Science department at Medical College of WisconsinLiliana 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
Activities of Daily LivingAdult
Amputees
Artificial Limbs
Disability Evaluation
Female
Humans
Interviews as Topic
Leg
Male
Middle Aged
Patient Satisfaction
Postoperative Care
Prospective Studies
Rehabilitation Centers
Treatment Outcome
