A Depiction of Rehabilitation Patients 65 Years and Younger With Dysvascular Lower Extremity Amputation

A L Mayo; S R Cimino; S L Hitzig

doi:10.33137/cpoj.v2i1.31950

A Depiction of Rehabilitation Patients 65 Years and Younger With Dysvascular Lower Extremity Amputation

Can Prosthet Orthot J. 2019 Feb 27;2(1):31950. doi: 10.33137/cpoj.v2i1.31950. eCollection 2019.

Authors

A L Mayo^{1

2}, S R Cimino³, S L Hitzig^{3

4

5}

Affiliations

¹ St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto, Canada.
² Faculty of Medicine, University of Toronto, Toronto, Canada.
³ St. John's Rehab Research Program, Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.
⁴ Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada.
⁵ Department of Occupational Science & Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada.

Abstract

Background: The majority of lower limb amputations (LLA) in Canada are dysvascular due to complications of diabetes and/or vascular disease. Traditionally dysvascular amputations have occurred in the elderly. With younger onset of adult diabetes, amputations are now occurring in non-geriatric populations. An understanding of younger patients with dysvascular LLA is needed to determine their risk factors, and unique health and psychosocial challenges.

Objectives: To obtain a depiction of the key demographic and impairment characteristics of adults 65 years and younger with dysvascular LLA undergoing inpatient rehabilitation.

Methodology: A retrospective chart review was completed on inpatient adult amputation rehabilitation patients over a five year period. Data extracted included socio-demographics, Functional Independence Measure (FIM) scores, comorbidities, and discharge outcomes.

Findings: One hundred and forty-three patients who were 65 years and younger were included, which represented almost a quarter of all admissions. Most patients were male (79%) with an average age of 55 years old (SD=8). The majority (72%) were unemployed. The mean number of co-morbidities was 5.2 (SD=8.2). Individuals discharged home (n=122) had higher (p<0.05) FIM scores than those readmitted to acute care or discharged to long-term care (n=20).

Conclusions: Similar to the literature on older dysvascular LLA patients, our study found high rates of disability and co-morbidities in younger patients with dysvascular LLA, which might impact their ability to work. Given these challenges, better amputation prevention strategies and targeted rehabilitation programming for this population are needed.

Keywords: Amputation; Dysvascular; Limb loss; inpatient rehabilitation; lower extremity; outcomes; sociodemographics.