title: Long-term outcomes and survival of patients with bilateral transtibial amputations after rehabilitation.
abstract: OBJECTIVE
  To examine long-term outcomes and survival of patients after bilateral transtibial amputation (BTTA).
  
  
  METHODS
  A retrospective chart review and a cross-sectional interview was conducted at Amputee Rehabilitation Service, West Park Healthcare Centre, Toronto, Canada, with consecutive diabetic or vascular BTTA patients (n = 82) admitted for rehabilitation from 1998 to 2003. Main outcome measures included the Houghton scale of prosthetic use, SF-12, Frenchay Activities Index, and qualitative measurement of activities of daily living (ADL).
  
  
  RESULTS
  Of 82 patients admitted for BTTA rehabilitation, 34 patients were interviewed an average of 3.7 yrs after amputation. Another 32 patients had died. Life expectancy was 4.2 yrs beyond rehabilitation discharge (Kaplan-Meier survival analysis). The mean modified Houghton score at telephone follow-up was 6.3 (maximum score of 9), with a significant improvement from rehabilitation discharge to follow-up (P = 0.001). Eighty-five percent were still wearing prostheses regularly and were walking. Most remained independent in ADLs.
  
  
  CONCLUSIONS
  Patients undergoing rehabilitation for BTTA continue to do well at long-term follow-up and to survive, on average, for more than 4 yrs after discharge. Therefore, they should be given strong consideration for prosthetic fitting.
authors.affiliation: Division of Physiatry, Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Heather L
authors.initials: HL
authors.lastname: Mac Neill
authors.forename: Michael
authors.initials: M
authors.lastname: Devlin
authors.forename: Tim
authors.initials: T
authors.lastname: Pauley
authors.forename: Alexandra
authors.initials: A
authors.lastname: Yudin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000671:Amputation, Surgical / Q000401:mortality* / Q000534:rehabilitation*; D001186:Artificial Limbs; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007866:Leg; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome