Association between Functional Severity and Amputation Type with Rehabilitation Outcomes in Patients with Lower Limb Amputation.
The purpose of this study was to determine independent influences of functional level and lower limb amputation type on inpatient rehabilitation outcomes. We conducted a secondary data analysis for patients with lower limb amputation who received inpatient medical rehabilitation (N = 26,501). The study outcomes included length of stay, discharge functional status, and community discharge. Predictors included the 3-level case mix group variable and a 4-category amputation variable. Age of the sample was 64.5 years (13.4) and 64% were male. More than 75% of patients had a dysvascular-related amputation. Patients with bilateral transfemoral amputations and higher functional severity experienced longest lengths of stay (average 13.7 days) and lowest functional rating at discharge (average 79.4). Likelihood of community discharge was significantly lower for those in more functionally severe patients but did not differ between amputation categories. Functional levels and amputation type are associated with rehabilitation outcomes in inpatient rehabilitation settings. Patients with transfemoral amputations and those in case mix group 1003 (admission motor score less than 36.25) generally experience poorer outcomes than those in other case mix groups. These relationships may be associated with other demographic and/or health factors, which should be explored in future research.
Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Boulevard, Mail Route No. 1137, Galveston, TX 77555, USA.
Amol M
0000-0001-8355-1585
AM
Karmarkar
Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Boulevard, Mail Route No. 1137, Galveston, TX 77555, USA.
James E
JE
Graham
Occupational Therapy Department, University of Texas Medical Branch, Galveston, TX, USA.
Timothy A
TA
Reistetter
Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Boulevard, Mail Route No. 1137, Galveston, TX 77555, USA.
Amit
A
Kumar
Uniform Data System for Medical Rehabilitation, A Division of UB Foundation Activities Inc. and Department of Rehabilitation Medicine, University at Buffalo, Buffalo, NY, USA.
Jacqueline M
0000-0002-5033-9630
JM
Mix
Uniform Data System for Medical Rehabilitation, A Division of UB Foundation Activities Inc. and Department of Rehabilitation Medicine, University at Buffalo, Buffalo, NY, USA.
Paulette
P
Niewczyk
Uniform Data System for Medical Rehabilitation, A Division of UB Foundation Activities Inc. and Department of Rehabilitation Medicine, University at Buffalo, Buffalo, NY, USA.
Carl V
CV
Granger
Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Boulevard, Mail Route No. 1137, Galveston, TX 77555, USA.
Kenneth J
KJ
Ottenbacher