Changing dynamics in lower-extremity amputation in China.
OBJECTIVE
To evaluate the current pattern of lower-extremity amputation (LEA) in a Chinese population and to identify independent risk factors for failure to ambulate in the community after LEA.


METHODS
Retrospective study.


METHODS
Tertiary hospital.


METHODS
Consecutive Chinese adults (N=189) who underwent LEA from 1995 to 1997.


METHODS
Not applicable.


METHODS
Pattern of LEA in comparison with previous data and risk factors for failure to ambulate in the community after LEA.


RESULTS
The mean age at amputation was 74.1 years. Vascular occlusive disease and infection accounted for most of the reasons for the LEA. The pattern of LEA had changed significantly. The proportion of patients who were able to ambulate in the community decreased from 66.1% before the LEA to 29.9% 12 months after LEA. Logistic regression analysis showed that major amputation level, presence of diabetes mellitus, hypertension, inability to ambulate in the community before LEA, and failed use of prosthesis were significant independent risk factors for failure to ambulate in the community after LEA.


CONCLUSIONS
A more aggressive rehabilitation approach, together with efforts targeted at various levels is required to achieve better functional ambulation level and to improve reintegration into the community after LEA.
Wan-Nar Wong
Margaret
M
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong. mwnwong@cuhk.edu.hk
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000534:rehabilitation* / Q000706:statistics & numerical data*; D001186:Artificial Limbs; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D017755:Prosthesis Fitting; D020127:Recovery of Function; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution