title: Lower-limb amputee rehabilitation in Australia: analysis of a national data set 2004-10.
abstract: OBJECTIVE
  Examine demographics, clinical characteristics and rehabilitation outcomes of lower-limb amputees, using the Australasian Rehabilitation Outcomes Centre (AROC) database.
  
  
  METHODS
  Lower-limb amputee rehabilitation separations between 2004 and 2010 were identified using AROC impairment codes 5.3-5.7.(1) Analysis was conducted by year, impairment code, Australian National Sub-acute and Non-Acute Patient (AN-SNAP) classification (S2-224, Functional Independence Measure (FIM) motor(Mot) score 72-91; S2-225, FIM (Mot) score 14-71) and states of Australia.
  
  
  RESULTS
  Mean length of stay (LOS) for all lower-limb amputee episodes was 36.1 days (95% confidence interval (CI): 35.4-36.9). Majority of episodes were unilateral below knee (63.6%), males (71.8%) with a mean age of 67.9 years (95% CI: 67.6-68.3). Year-on-year analysis revealed a trend for increasing LOS and decreasing age. Analysis by impairment code demonstrated no significant difference in rehabilitation outcomes. Analysis by AN-SNAP found that LOS was 16.2 days longer for S2-225 than for S2-224 (95% CI: 14.7-17.8, P<0.001), and FIM (Mot) change was 12.0 points higher for S2-225 than for S2-224 (95% CI: 11.5-12.6, P<0.001). Analysis by states revealed significant variation in LOS, FIM (Mot) change and FIM (Mot) efficiency which may be associated with variations in organisation of rehabilitation services across states.
  
  
  CONCLUSIONS
  Although amputees represented a comparatively small proportion of all rehabilitation episodes in Australia, their LOS was significant. Unlike many other rehabilitation conditions, there was no evidence of decreasing LOS over time. AN-SNAP classes were effective in distinguishing rehabilitation outcomes, and could potentially be used more effectively in planning rehabilitation programs.
authors.affiliation: Department of Rehabilitation, Aged and Extended Care, Flinders University, Repatriation General Hospital, Daws Road, Daw Park, SA 5041, Australia. brenton.hordarce@health.sa.gov.au
authors.forename: Brenton G
authors.initials: BG
authors.lastname: Hordacre
authors.forename: Tara
authors.initials: T
authors.lastname: Stevermuer
authors.forename: Frances
authors.initials: F
authors.lastname: Simmonds
authors.forename: Maria
authors.initials: M
authors.lastname: Crotty
authors.forename: Kathy
authors.initials: K
authors.lastname: Eagar
mesh_terms: D000368:Aged; D000674:Amputees / Q000534:rehabilitation*; D001315:Australia; D005260:Female; D006801:Humans; D007902:Length of Stay; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D020127:Recovery of Function; D012189:Retrospective Studies