Preoperative Factors Influencing Functional Rehabilitation after Major Lower Limb Amputation and Validation of a Preoperative Scoring Tool

Abstract

Introduction: The ability to walk with prosthesis is a major determinant of functional independence after major lower limb (MLL) amputation. The Blatchford Leicester Allman-Russell Tool (BLARt) score is a potentially valuable tool that can predict the functional outcome after MLL amputation. The study aimed to identify preoperative factors that influence functional rehabilitation after MLL amputation and validation of BLARt score. Methods: This retrospective study analyzed 71 patients referred for rehabilitation postamputation. The level of functional outcome at 6 and 12 months were recorded using Special Interest Group in Amputee Medicine grading. Preoperative factors and BLARt score were analyzed for association with functional outcome. Results: BLARt score was found to have a significant correlation with functional outcome in 6 and 12 months. BLARt showed a fair to good predictive ability with an area under the receiver operating characteristic curve of 0.713 (SE 0.61, 95% confidence intervals 0.593–0.832) and 0.705 (SE 0.061, 95% confidence intervals 0.585–0.825) for the nonfunctional outcome at 6 and 12 months, respectively. Preoperative mobility was the only significant risk factor that was associated with functional mobility (P = 0.02). Conclusion: With the validation analysis showing a fair to good predictive ability, BLARt score does serve its proposed role in risk stratification.