Identifying Factors Predicting Hospital Length-of stay and Receiving Prosthesis of Lower Limb Amputee Patients after Amputation Surgery- A Singapore Perspective

Abstract

Abstract Aims To identify predictors affecting total hospital length of stay(TLOS) and receiving lower limb prosthesis of amputees after surgery in a Singapore tertiary hospital. Materials and Methods A retrospective study of 96 patients was undertaken with various levels of lower limb amputation admitted to Singapore General Hospital (SGH) from January 2009 to December 2014. Patients were divided into two groups: 40-59 and 60 to 80 years old. We correlate clinical variables with TLOS and receiving prosthesis at 6 months from surgery. Results For the cohort of age 40-59, presence of IHD (B=22.4), wound infection (B=17.8) and those needing inpatient rehabilitation(B=36.8) correlate to increased TLOS. Premorbid independence (B=28.6) and presence of care-giver (B=23.3) led to a reduction of TLOS. For successful receiving of prosthesis at 6months from surgery, diabetes (B=0.69) and CRF (B=0.31)were negative predictors. In the older cohort, presence of care-giver (B=18.6) predicted shorter TLOS whereas those needing inpatient rehabilitation contributed to longer TLOS(B=25.61). Those who needed for inpatient rehabilitation had statistically signifi cant higher chance of receiving prosthesis later(B=0.53). Conclusion IHD, wound infection and need for inpatient rehabilitation, premorbid independence and care-giver availability are important predictors of TLOS. For receiving of prosthesis at 6months, predictors include needing inpatient rehabilitation, diabetes and CRF.