Factors Associated With Prolonged Length of Stay and Failed Lower Limb Prosthetic Fitting During Inpatient Rehabilitation

Abstract

ObjectiveTo identify variables associated with rehabilitation length of stay (LOS) and prosthetic fitting success for people with lower limb amputation (LLA). DesignRetrospective analysis of clinically collected cohort. SettingCanadian inpatient rehabilitation hospital. ParticipantsConsecutive individuals with LLA (N=103) admitted for prosthetic fitting (mean age, 65.3±10.6y). InterventionsNot applicable. Main Outcome MeasuresIndependent variables included the Lower Limb Amputee Measurement Scale (LLAMS), which is a 31-question tool to predict LOS with items in medical, cognitive, social, physical, activities of daily living, and other subsections; admission FIM; age; sex; level of amputation (below- or above-knee); and time from surgery to admission. LOS was measured as days from admission to discharge. Successful prosthetic fitting was defined as the ability to use a prosthesis on discharge. ResultsThe mean LOS was 63.6 ± 33.3 days, and 21.4% of patients failed prosthetic fitting. Higher LLAMS, lower FIM, and above-knee amputation were significantly associated with longer LOS (P<.001, R2=0.36). Age, sex, and time from surgery were not significantly associated with LOS or prosthetic fitting. Higher LLAMS was significantly associated with unsuccessful prosthetic fitting (P=.032). Of the 31 items in the LLAMS, 5 were associated with prolonged LOS and 5 were associated with failed prosthetic fitting (P<.10). ConclusionsThe LLAMS, level of amputation, and admission FIM can be used to predict LOS in lower limb amputees admitted for prosthetic fitting. The LLAMS was weak in identifying patients who failed prosthetic fitting. Future research should consider shortening the LLAMS.