Venous thromboembolism in a rehabilitation setting after major lower-extremity amputation.
OBJECTIVE
To determine the prevalence of venous thromboembolic disease (VTED) and impact on functional outcome in patients with major lower-extremity (LE) amputation admitted to an inpatient rehabilitation unit.


METHODS
Retrospective medical records review.


METHODS
Acute inpatient rehabilitation unit in a tertiary, urban academic medical center.


METHODS
Fifty consecutive patients admitted to an acute inpatient rehabilitation unit after a major LE amputation. Participants were screened at rehabilitation admission for LE deep vein thrombosis using duplex ultrasonography.


METHODS
Not applicable. Main outcome measures VTED incidence, FIM instrument, total rehabilitation charges, and length of stay (LOS).


RESULTS
Six of 50 patients (12%) had evidence of VTED. The VTED cohort had significantly lower admission and discharge FIM scores than the no-VTED cohort (admission FIM score, 57.2 vs 76.0; discharge FIM score, 66.0 vs 90.1, respectively; P< or =.02). Subjects with VTED had a longer rehabilitation LOS (22.8d vs 13.9d, respectively; P=.02) and higher total rehabilitation charges (28,314 US dollars vs 17,724 US dollars, respectively; P<.05).


CONCLUSIONS
In this study, VTED prevalence after LE amputation in a rehabilitation setting was 12%. Subjects with VTED had lower admission and discharge functional status, longer LOS, and higher hospital charges. The utility of screening duplex ultrasound examinations at rehabilitation admission remains unclear.
Huang
Mark E
ME
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA. mhuang@ric.org
Johns
Jeffery S
JS
White
Joy
J
Sanford
Kim
K
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000009:adverse effects* / Q000191:economics / Q000534:rehabilitation; D005260:Female; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000191:economics / Q000209:etiology*