Article

Prior studies have identified age as a factor in determining an
individual's likelihood of receiving a prosthesis following a lower limb
amputation. These studies are limited to specific subsets of the general
population and are unable to account for preamputation characteristics within
their study populations. Our study seeks to determine the effect of preamputation
characteristics on the probability of receiving a prosthesis for the general
population in the United States. OBJECTIVE: To identify preamputation
characteristics that predict of the likelihood of receiving a prosthesis
following an above-knee amputation. DESIGN: A retrospective, population-based
cohort study. SETTING: Olmsted County, Minnesota (2010 population: 144,248).
PARTICIPANTS: Individuals (n = 93) over the age of 18 years who underwent an
above-knee amputation, that is, knee disarticulation or transfemoral amputation,
while residing in Olmsted County, MN, between 1987 and 2013. METHODS:
Characteristics affecting the receipt of a prosthesis were analyzed using a
logistic regression and a random forest algorithm for classification trees.
Preamputation characteristics included age, gender, amputation etiology, year of
amputation, mobility, cognitive ability, comorbidities, and time between surgery
and the prosthesis decision. MAIN OUTCOME MEASURES: The association of
preamputation characteristics with the receipt of a prosthesis following an
above-knee amputation. RESULTS: Twenty-four of the participants received a
prosthesis. The odds of receiving a prosthesis were almost 30 times higher in
those able to walk independently prior to an amputation relative to those who
could not walk independently. A 10-year increase in age was associated with a
53.8% decrease in the likelihood of being fit for a prosthesis (odds ratio =
0.462, P =.030). Time elapsed between surgery and the prosthesis decision was
associated with a rise in probability of receiving a prosthesis for the first 3
months in the random forest algorithm. No other observed characteristics were
associated with receipt of a prosthesis. CONCLUSIONS: The association of
preamputation mobility and age with the likelihood of being fit for a prosthesis
is well understood. The effect of age, after controlling for confounders, still
persists and is associated with the likelihood of being fit for a prosthesis.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS