title: Weight Change Trajectories After Incident Lower-Limb Amputation.
abstract: OBJECTIVE
  To characterize weight change after amputation by identifying typical weight trajectories in men with incident lower-limb amputation (LLA) and describing characteristics associated with each trajectory.
  
  
  METHODS
  Retrospective cohort study and analyzed using group-based trajectory modeling.
  
  
  METHODS
  Administrative data.
  
  
  METHODS
  Veterans who were men (N=759), living in the Northwest United States, and who had an incident toe, foot, or leg amputation between 1997 and 2008 and at least 18 months of amputation-free survival thereafter.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Postamputation weight and body mass index change.
  
  
  RESULTS
  The mean weight at baseline was 91.6±24 kg (202±53 lb), and average follow-up was 2.4 years. We identified 4 trajectory groups for weight change: weight loss (13%), stable weight (47%), slow weight gain (33%), and rapid weight gain (7%). Men with a toe or foot amputation most frequently were assigned to the stable weight group (58%), whereas men with transtibial or transfemoral amputations were most commonly assigned to the slow weight gain group (42% each). Men who died during follow-up were more likely to be assigned to the weight loss group (24%) than men who did not die (11%).
  
  
  CONCLUSIONS
  We identified distinct weight change trajectories that represent heterogeneity in weight change after LLA. An improved understanding of factors predictive of weight gain or loss in people with LLA may help better target rehabilitation and prosthetic prescription. Additional research is needed to fully understand the relation between weight change and health status after amputation.
authors.affiliation: Health Services Research and Development, Department of Veterans Affairs Medical Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA. Electronic address: Erin.Bouldin@va.gov.
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bouldin
authors.affiliation: Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Medical Center, Seattle, WA; Department of Biostatistics, University of Washington, Seattle, WA.
authors.forename: Mary Lou
authors.initials: ML
authors.lastname: Thompson
authors.affiliation: Health Services Research and Development, Department of Veterans Affairs Medical Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA; Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Medical Center, Seattle, WA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.affiliation: Rehabilitation Research and Development Center of Excellence for Limb Loss Prevention and Prosthetic Engineering, Department of Veterans Affairs Medical Center, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: David C
authors.initials: DC
authors.lastname: Morgenroth
authors.affiliation: Health Services Research and Development, Department of Veterans Affairs Medical Center, Seattle, WA; Department of Epidemiology, University of Washington, Seattle, WA; Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Medical Center, Seattle, WA.
authors.forename: Alyson J
authors.initials: AJ
authors.lastname: Littman
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D015992:Body Mass Index; D015897:Comorbidity; D005269:Femur / Q000601:surgery; D006801:Humans; D007866:Leg / Q000601:surgery; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013977:Tibia / Q000601:surgery; D014034:Toes / Q000601:surgery; D015430:Weight Gain; D015431:Weight Loss
keywords: Amputation; Body weight changes; Lower extremity; Rehabilitation; Veterans