Effects of prosthetic limb prescription on 3-year mortality among Veterans with lower-limb amputation.
Our objective was to determine the relationship between receipt of a prescription for a prosthetic limb and 3 yr mortality postsurgery among Veterans with lower-limb amputation (LLA). We conducted a retrospective observational study that included 4,578 Veterans hospitalized for LLA and discharged in fiscal years 2003 and 2004. The outcome was time to all-cause mortality from the amputation surgical date up to the 3 yr anniversary of the surgical date. Of the Veterans with LLA, 1,300 (28.4%) received a prescription for a prosthetic limb within 1 yr after the surgical amputation. About 46% (n = 2,086) died within 3 yr of the surgical anniversary. Among those who received a prescription for a prosthetic limb, only 25.2% died within 3 yr of the surgical anniversary. After adjustment, Veterans who received a prescription for a prosthetic limb were less likely to die after the surgery than Veterans without a prescription, with a hazard ratio of 0.68 (95% confidence interval: 0.60-0.77). Findings demonstrated that Veterans with LLA who received a prescription for a prosthetic limb within 1 yr after the surgical amputation were less likely to die within 3 yr of the surgical amputation after controlling for patient-, treatment-, and facility-level characteristics.
Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, PA;
Jibby E
JE
Kurichi
Pui
P
Kwong
W Bruce
WB
Vogel
Dawei
D
Xie
Diane
D
Cowper Ripley
Barbara E
BE
Bates
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000401:mortality*; D001186:Artificial Limbs; D015897:Comorbidity; D005260:Female; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications / Q000401:mortality; D015996:Survival Rate; D014728:Veterans
Veterans; amputation; lower-limb amputation; methods; mortality; outcomes; prosthesis; prosthetic limb; retrospective studies; time-dependent covariate