Routing through the health care system and level of functioning of lower limb amputees

Autor: J. C. Sier, M. Terburg, S. C. Remerie, Henk J. Stam, A. E. M. Uiterwijk, M. Rol
Přispěvatelé: Rehabilitation Medicine
Rok vydání: 1997
Předmět:
Male
030506 rehabilitation
medicine.medical_treatment
Prosthesis
Cohort Studies
0302 clinical medicine
Postoperative Complications
Risk Factors
Health care
Activities of Daily Living
Ambulatory Care
Medicine
Netherlands
Aged
80 and over
Medical record
Incidence
Rehabilitation
Health Care Costs
Middle Aged
Survival Rate
medicine.anatomical_structure
Female
0305 other medical science
Cohort study
Adult
medicine.medical_specialty
Physical Therapy
Sports Therapy and Rehabilitation
Rehabilitation Centers
Lower limb
Amputation
Surgical
03 medical and health sciences
Appointments and Schedules
Age Distribution
Humans
Sex Distribution
Aged
Retrospective Studies
Leg
business.industry
Vascular disease
Length of Stay
medicine.disease
Nursing Homes
Logistic Models
Amputation
Physical therapy
Patient Care
Ankle
business
030217 neurology & neurosurgery
Follow-Up Studies
Zdroj: Clinical Rehabilitation, 11(3), 252-263. SAGE Publications Ltd
ISSN: 0269-2155
Popis: Objectives: To describe the routing through the health care system and the level of functioning of a consecutive series of lower limb amputees at a general Dutch hospital.Methods: A descriptive cohort study (medical records examination) with a follow-up interval of 11.7 months. All 124 major lower limb amputations (ankle to hip) between 1 July 1989 and 31 December 1992 are included in the study: 123 patients, average age 73.8 years, 96% vascular disease. Amputation levels are 55.3% transfemoral, 12.2% knee disarticulation and 32.5% transtibial. At follow-up two patients are missing.Results: Before admission to hospital 75.6% of patients are able to walk and 79.9% live independently. Discharge destinations from hospital are 22.5% home, 42.3% inpatient rehabilitation and 32.4% nursing home. At follow-up, 59% of surviving patients have a prosthesis, 47.7% are able to walk and 70.5% live independently. Mortality after one year is 28.5%. Poor preoperative walkers seem to die more often within the first year and have less chance of being fitted with a prosthesis. Poor walkers, older than 75, with diabetes mellitus and a transfemoral amputation seem to stay more often in a nursing home after one year.Discussion: Although the results are largely comparable with other studies, there appear to be differences in age, amputation level and course and duration of treatment. The predicting factors found here may help the rehabilitation specialist in advising on the best moment and level of amputation and course of treatment.
Databáze: OpenAIRE
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