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Association between Functional Severity and Amputation Type with Rehabilitation Outcomes in Patients with Lower Limb Amputation.

Karmarkar AM, Graham JE, Reistetter TA, Kumar A, Mix JM, Niewczyk P, Granger CV, Ottenbacher KJ - Rehabil Res Pract (2014)

Bottom Line: The study outcomes included length of stay, discharge functional status, and community discharge.Patients with transfemoral amputations and those in case mix group 1003 (admission motor score less than 36.25) generally experience poorer outcomes than those in other case mix groups.These relationships may be associated with other demographic and/or health factors, which should be explored in future research.

View Article: PubMed Central - PubMed

Affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Boulevard, Mail Route No. 1137, Galveston, TX 77555, USA.

ABSTRACT
The purpose of this study was to determine independent influences of functional level and lower limb amputation type on inpatient rehabilitation outcomes. We conducted a secondary data analysis for patients with lower limb amputation who received inpatient medical rehabilitation (N = 26,501). The study outcomes included length of stay, discharge functional status, and community discharge. Predictors included the 3-level case mix group variable and a 4-category amputation variable. Age of the sample was 64.5 years (13.4) and 64% were male. More than 75% of patients had a dysvascular-related amputation. Patients with bilateral transfemoral amputations and higher functional severity experienced longest lengths of stay (average 13.7 days) and lowest functional rating at discharge (average 79.4). Likelihood of community discharge was significantly lower for those in more functionally severe patients but did not differ between amputation categories. Functional levels and amputation type are associated with rehabilitation outcomes in inpatient rehabilitation settings. Patients with transfemoral amputations and those in case mix group 1003 (admission motor score less than 36.25) generally experience poorer outcomes than those in other case mix groups. These relationships may be associated with other demographic and/or health factors, which should be explored in future research.

No MeSH data available.


Related in: MedlinePlus

Discharge FIM rating by amputation levels for case mix group after adjustment of function. ul = unilateral, bl = bilateral, TF = transfemoral, and TT = transtibial.
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Related In: Results  -  Collection


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fig2: Discharge FIM rating by amputation levels for case mix group after adjustment of function. ul = unilateral, bl = bilateral, TF = transfemoral, and TT = transtibial.

Mentions: Without adjusting for other covariates, patients with bilateral transfemoral level of amputation under CMG 1003 had the highest LOS (13.7 days) as compared to patients with other levels of amputation and CMG. Those with unilateral transtibial level of amputation under CMG 1001 had the lowest LOS in IRF (7.2 days) (Figure 1). Discharge functional rating was lowest for those with bilateral transfemoral level of amputation under CMG 1003 (79.4) and highest for those with unilateral transtibial level of amputation under CMG 1001 (105.6) (Figure 2). Proportion of discharge to community was lowest among patients categorized into CMG 1003 compared to those under either 1002 or 1001, irrespective of amputation levels. This proportion was also lower for those patients under CMG 1002 than CMG 1001 for all except bilateral transtibial amputation level (Figure 3).


Association between Functional Severity and Amputation Type with Rehabilitation Outcomes in Patients with Lower Limb Amputation.

Karmarkar AM, Graham JE, Reistetter TA, Kumar A, Mix JM, Niewczyk P, Granger CV, Ottenbacher KJ - Rehabil Res Pract (2014)

Discharge FIM rating by amputation levels for case mix group after adjustment of function. ul = unilateral, bl = bilateral, TF = transfemoral, and TT = transtibial.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4221898&req=5

fig2: Discharge FIM rating by amputation levels for case mix group after adjustment of function. ul = unilateral, bl = bilateral, TF = transfemoral, and TT = transtibial.
Mentions: Without adjusting for other covariates, patients with bilateral transfemoral level of amputation under CMG 1003 had the highest LOS (13.7 days) as compared to patients with other levels of amputation and CMG. Those with unilateral transtibial level of amputation under CMG 1001 had the lowest LOS in IRF (7.2 days) (Figure 1). Discharge functional rating was lowest for those with bilateral transfemoral level of amputation under CMG 1003 (79.4) and highest for those with unilateral transtibial level of amputation under CMG 1001 (105.6) (Figure 2). Proportion of discharge to community was lowest among patients categorized into CMG 1003 compared to those under either 1002 or 1001, irrespective of amputation levels. This proportion was also lower for those patients under CMG 1002 than CMG 1001 for all except bilateral transtibial amputation level (Figure 3).

Bottom Line: The study outcomes included length of stay, discharge functional status, and community discharge.Patients with transfemoral amputations and those in case mix group 1003 (admission motor score less than 36.25) generally experience poorer outcomes than those in other case mix groups.These relationships may be associated with other demographic and/or health factors, which should be explored in future research.

View Article: PubMed Central - PubMed

Affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Boulevard, Mail Route No. 1137, Galveston, TX 77555, USA.

ABSTRACT
The purpose of this study was to determine independent influences of functional level and lower limb amputation type on inpatient rehabilitation outcomes. We conducted a secondary data analysis for patients with lower limb amputation who received inpatient medical rehabilitation (N = 26,501). The study outcomes included length of stay, discharge functional status, and community discharge. Predictors included the 3-level case mix group variable and a 4-category amputation variable. Age of the sample was 64.5 years (13.4) and 64% were male. More than 75% of patients had a dysvascular-related amputation. Patients with bilateral transfemoral amputations and higher functional severity experienced longest lengths of stay (average 13.7 days) and lowest functional rating at discharge (average 79.4). Likelihood of community discharge was significantly lower for those in more functionally severe patients but did not differ between amputation categories. Functional levels and amputation type are associated with rehabilitation outcomes in inpatient rehabilitation settings. Patients with transfemoral amputations and those in case mix group 1003 (admission motor score less than 36.25) generally experience poorer outcomes than those in other case mix groups. These relationships may be associated with other demographic and/or health factors, which should be explored in future research.

No MeSH data available.


Related in: MedlinePlus