title: Low vitamin B12 in patients on admission to an amputation rehabilitation unit: a retrospective study.
abstract: OBJECTIVE
  The purpose of this study was to determine the prevalence of low vitamin B12 (VB12) in patients on admission to an amputation rehabilitation unit and identify specific populations at risk.
  
  
  METHODS
  A retrospective chart review was performed for 127 participants comprising patients with major lower limb amputations admitted to a regional amputation rehabilitation program between January 1, 2011 and December 31, 2012. Electronic medical records were reviewed for demographic data, amputation data, medication history, serum VB12 levels, and other related blood work. A literature-based cutoff of VB12 <260 pmol/L was used as the criterion for low VB12.
  
  
  RESULTS
  The prevalence of low VB12 was 59.8%. Patients aged ≥55 years were found to have an increased prevalence of low VB12 (P = .05). Serum VB12 levels were significantly lower among patients aged ≥55 years (P < .05) and among patients with a mean corpuscular volume >97 fL (P < .01). No other differences in prevalence were determined among different demographics, etiologies, or comorbidities.
  
  
  CONCLUSIONS
  Patients with an amputation have a high prevalence of low VB12 levels compared with the general population. Low VB12 status may impact rehabilitation outcomes through anemia, cognitive decline, and neuropathy. No reliable indicators for which patients should be screened were found, and therefore, a universal approach to screening and treatment is needed.
authors.affiliation: Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Earl
authors.affiliation: Department of Physiology, Western University, London, Ontario, Canada.
authors.forename: Renee
authors.initials: R
authors.lastname: Wong
authors.affiliation: Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada Regional Amputee Program, St Joseph's Health Care, London, Ontario, Canada michael.payne@sjhc.london.on.ca.
authors.forename: Michael W C
authors.initials: MW
authors.lastname: Payne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000379:methods / Q000534:rehabilitation*; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012046:Rehabilitation / Q000379:methods; D012189:Retrospective Studies; D014805:Vitamin B 12 / Q000008:administration & dosage* / Q000097:blood; D014806:Vitamin B 12 Deficiency / Q000097:blood / Q000175:diagnosis* / Q000178:diet therapy* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014805:Vitamin B 12
keywords: amputation; amputees; mass screening; rehabilitation centers; vitamin B12; vitamin B12 deficiency