Rehabilitation of the geriatric vascular amputee patient: a population-based study.
OBJECTIVE
To determine the rate of successful prosthetic fitting in geriatric vascular amputees in the community and to determine predictors of successful fit.


METHODS
Epidemiologic survey.


METHODS
General community, Olmsted County, Minnesota.


METHODS
All Olmsted County residents more than 65 years old who had a major lower extremity amputation (below knee amputation [BKA] or higher) for peripheral vascular disease between 1974-1995, of whom 199 were identified. Median age at amputation was 79.7 years with a median survival of 1.5 years.


METHODS
A retrospective chart review.


METHODS
Successful prosthetic fit.


RESULTS
Amputation levels were: 64% BKA, 4.5% knee disarticulation, 31% above knee amputation (AKA), and 0.5% hip disarticulation. Only 36% of the population was successfully fitted, compared with 74% of patients referred to the Amputee Clinic. Major reasons for not being fitted included death, reamputation, cerebrovascular disease, and cognitive deficits. Increased age (p < .001), cerebrovascular disease (p < .001), dementia (p = .002), and AKA (p < .001) were associated with failure to fit.


CONCLUSIONS
The high probability of successful prosthetic fitting reported among referral practices cannot be generalized to unselected elderly individuals. However, selected individuals can successfully be fitted with a prosthesis; knowledge of predictors of prosthetic fitting may facilitate setting of realistic goals during presurgical counseling in this age group.
Fletcher
D D
DD
Department of Physical Medicine and Rehabilitation, Mayo Clinic Rochester, Rochester, MN 55902, USA.
Andrews
K L
KL
Butters
M A
MA
Jacobsen
S J
SJ
Rowland
C M
CM
Hallett
J W
JW
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000534:rehabilitation*; D001186:Artificial Limbs; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008910:Minnesota; D015999:Multivariate Analysis; D016017:Odds Ratio; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000601:surgery*