Defining successful mobility after lower extremity amputation for complications of peripheral vascular disease and diabetes

J Vasc Surg. 2011 Aug;54(2):412-9. doi: 10.1016/j.jvs.2011.01.046. Epub 2011 Apr 30.

Abstract

Background: Information about longer-term functional outcomes following lower extremity amputation for peripheral vascular disease and diabetes remains limited. This study examined factors associated with mobility success during the first year following amputation.

Methods: Prospective cohort study of 87 amputees experiencing a first major unilateral amputation surgery. Seventy-five (86%) participants completed 12-month follow-up interview.

Results: Twenty-eight subjects (37%) achieved mobility success, defined as returning to or exceeding a baseline level of mobility on the locomotor capability index (LCI-5). Forty-three subjects (57%) were satisfied with their mobility. Individuals who were 65 years of age and older (risk difference [RD] = -0.52; 95% confidence interval [CI]: -0.75, -0.29), reported a current alcohol use disorder (RD = -0.37; 95% CI: -0.48, -0.26), had a history of hypertension (RD = -0.23; 95% CI: -0.43, -0.03) or treatment for anxiety or depression (RD = -0.39; 95% CI: -0.50, -0.28) were less likely to achieve mobility success. Mobility success was associated with mobility satisfaction (RD = 0.36; 95% CI: 0.20, 0.53) and satisfaction with life (RD = 0.28; 95% CI: 0.06, 0.50). Although higher absolute mobility at 12 months was also associated with mobility satisfaction and overall life satisfaction, 50% of individuals who achieved success with low to moderate 12-month mobility function reported they were satisfied with their mobility.

Conclusion: Defining success after amputation in relation to an individual's specific mobility prior to the development of limb impairment which led to amputation provides a useful, patient-centered measure that takes other aspects of health, function, and impairment into account.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Amputation* / adverse effects
  • Analysis of Variance
  • Chi-Square Distribution
  • Diabetic Angiopathies / complications
  • Diabetic Angiopathies / diagnosis
  • Diabetic Angiopathies / physiopathology
  • Diabetic Angiopathies / surgery*
  • Disability Evaluation*
  • Female
  • Hospitals, Veterans
  • Humans
  • Logistic Models
  • Lower Extremity / blood supply*
  • Male
  • Middle Aged
  • Mobility Limitation
  • Motor Activity*
  • Patient Satisfaction
  • Peripheral Vascular Diseases / complications
  • Peripheral Vascular Diseases / diagnosis
  • Peripheral Vascular Diseases / physiopathology
  • Peripheral Vascular Diseases / surgery*
  • Prospective Studies
  • Quality of Life
  • Recovery of Function
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Washington