Re-amputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization
| Autor: | Minoru Okita, Koji Sato, Shinsuke Imaoka, Toshio Higashi, Masahide Furukawa |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Reoperation medicine.medical_specialty lcsh:Diseases of the musculoskeletal system medicine.medical_treatment Aftercare 030204 cardiovascular system & hematology Amputation Surgical Minor amputation 03 medical and health sciences Disability Evaluation 0302 clinical medicine Diabetes mellitus Quality of life Risk Factors medicine Humans Orthopedics and Sports Medicine 030212 general & internal medicine Mobility Limitation Amputation Physical Therapy Modalities Aged Proportional Hazards Models Retrospective Studies Rehabilitation business.industry Medical record Research Retrospective cohort study Middle Aged Functional Independence Measure Diabetic Foot Hospitalization Re-amputation medicine.anatomical_structure Functional Status Treatment Outcome Lower Extremity Physical therapy Female Hemodialysis lcsh:RC925-935 Ankle business |
| Zdroj: | Journal of Foot and Ankle Research Journal of Foot and Ankle Research, Vol 14, Iss 1, Pp 1-10 (2021) |
| ISSN: | 1757-1146 |
| Popis: | Background Diabetes-related foot lesions are a major cause of non-traumatic lower limb amputations and are associated with a high re-amputation rate. Lesions can cause hindrance in activities of daily living, reduce physical function, and lower a patient’s quality of life. Physical therapy is necessary to prevent these limitations. Thus far, there has been limited investigation into the re-amputation rate in patients who have undergone physical therapy. This study aimed to elucidate modifiable risk factors for re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization. Methods This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records to surgical and physical therapy units stored in the electronic medical records. We examined re-amputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was set at 1 year. We used Cox proportional hazards analysis to examine factors affecting the risk of re-amputation. Results Of the 129 patients enrolled, 42 patients (32.5%) underwent re-amputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with re-amputation were a requirement for hemodialysis, ankle dorsiflexion angle, and the Functional Independence Measure (FIM) ambulation score. Conclusions In diabetes patients with minor amputations, a requirement for hemodialysis, ankle dorsiflexion angle, and the FIM ambulation score were shown to be modifiable risk factors for re-amputation. This emphasizes that maintaining vascular endothelial function through lower limb muscle exercises for hemodialysis, improving ankle mobility, and relieving plantar pressure during walking are necessary to reduce the risk of re-amputation. Patients with these risk factors should be encouraged to participate in physical therapy. |
| Databáze: | OpenAIRE |
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