title: The impact of gender, level of amputation and diabetes on prosthetic fit rates following major lower extremity amputation.
abstract: BACKGROUND
  Diabetes mellitus is a leading cause of major lower extremity amputation.
  
  
  OBJECTIVE
  To examine the influence of gender, level of amputation and diabetes mellitus status on being fit with a prosthetic limb following lower extremity amputation for peripheral arterial disease.
  
  
  METHODS
  Retrospective analysis of the Scottish Physiotherapy Amputee Research Group dataset.
  
  
  RESULTS
  Within the cohort with peripheral arterial disease ( n = 1735), 64% were men ( n = 1112) and 48% ( n = 834) had diabetes mellitus. Those with diabetes mellitus were younger than those without: mean 67.5 and 71.1 years, respectively ( p < 0.001). Trans-tibial amputation:trans-femoral amputation ratio was 2.33 in those with diabetes mellitus, and 0.93 in those without. A total of 41% of those with diabetes mellitus were successfully fit with a prosthetic limb compared to 38% of those without diabetes mellitus. Male gender positively predicted fitting with a prosthetic limb at both trans-tibial amputation ( p = 0.001) and trans-femoral amputation ( p = 0.001) levels. Bilateral amputations and increasing age were negative predictors of fitting with a prosthetic limb ( p < 0.001). Diabetes mellitus negatively predicted fitting with a prosthetic limb at trans-femoral amputation level ( p < 0.001). Mortality was 17% for the cohort, 22% when the amputation was at trans-femoral amputation level.
  
  
  CONCLUSIONS
  Of those with lower extremity amputation as a result of peripheral arterial disease, those with diabetes mellitus were younger, and more had trans-tibial amputation. Although both age and amputation level are good predictors of fitting with a prosthetic limb, successful limb fit rates were no better than those without diabetes mellitus. Clinical relevance This is of clinical relevance to those who are involved in the decision-making process of prosthetic fitting following major amputation for dysvascular and diabetes aetiologies.
authors: 1 University of Glasgow, Glasgow, UK.
authors: Fiona
authors: F
authors: Davie-Smith
authors: 1 University of Glasgow, Glasgow, UK.
authors: Lorna
authors: L
authors: Paul
authors: 2 MRC, Glasgow, UK.
authors: Natalie
authors: N
authors: Nicholls
authors: 3 NHS GGC, Diabetes Centre, Southern General Hospital, Glasgow, UK.
authors: Wesley P
authors: WP
authors: Stuart
authors: 3 NHS GGC, Diabetes Centre, Southern General Hospital, Glasgow, UK.
authors: Brian
authors: B
authors: Kennon
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D001186:Artificial Limbs; D003925:Diabetic Angiopathies / Q000601:surgery*; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D058729:Peripheral Arterial Disease / Q000601:surgery*; D017755:Prosthesis Fitting; D012189:Retrospective Studies; D012737:Sex Factors
keywords: Diabetes; prosthetics; rehabilitation