Abstract
Background:Diabetes mellitus is a leading cause of major lower extremity amputation.Objective:To examine the influence of gender, level of amputation and diabetes mellitus status on being fit with a prosthetic limb following lower extremity amputation for peripheral arterial disease.Study design:Retrospective analysis of the Scottish Physiotherapy Amputee Research Group dataset.Results:Within the cohort with peripheral arterial disease (n = 1735), 64% were men (n = 1112) and 48% (n = 834) had diabetes mellitus. Those with diabetes mellitus were younger than those without: mean 67.5 and 71.1 years, respectively (p < 0.001). Trans-tibial amputation:trans-femoral amputation ratio was 2.33 in those with diabetes mellitus, and 0.93 in those without. A total of 41% of those with diabetes mellitus were successfully fit with a prosthetic limb compared to 38% of those without diabetes mellitus. Male gender positively predicted fitting with a prosthetic limb at both trans-tibial amputation (p = 0.001) and trans-femoral amputation (p = 0.001) levels. Bilateral amputations and increasing age were negative predictors of fitting with a prosthetic limb (p < 0.001). Diabetes mellitus negatively predicted fitting with a prosthetic limb at trans-femoral amputation level (p < 0.001). Mortality was 17% for the cohort, 22% when the amputation was at trans-femoral amputation level.Conclusion:Of those with lower extremity amputation as a result of peripheral arterial disease, those with diabetes mellitus were younger, and more had trans-tibial amputation. Although both age and amputation level are good predictors of fitting with a prosthetic limb, successful limb fit rates were no better than those without diabetes mellitus.Clinical relevanceThis is of clinical relevance to those who are involved in the decision-making process of prosthetic fitting following major amputation for dysvascular and diabetes aetiologies.
Highlights
IntroductionObjective: To examine the influence of gender, level of amputation and diabetes mellitus status on being fit with a prosthetic limb following lower extremity amputation for peripheral arterial disease
Diabetes mellitus is a leading cause of major lower extremity amputation
The aim of this study was to examine the impact of diabetes mellitus (DM), gender and the level of amputation on the rates of being fit with a prosthetic limb following non-traumatic major amputation in Scotland from 2007 to 2009, utilising data from the Scottish Physiotherapy Amputee Research Group (SPARG)
Summary
Objective: To examine the influence of gender, level of amputation and diabetes mellitus status on being fit with a prosthetic limb following lower extremity amputation for peripheral arterial disease. Diabetes mellitus negatively predicted fitting with a prosthetic limb at trans-femoral amputation level (p < 0.001). Conclusion: Of those with lower extremity amputation as a result of peripheral arterial disease, those with diabetes mellitus were younger, and more had trans-tibial amputation. Both age and amputation level are good predictors of fitting with a prosthetic limb, successful limb fit rates were no better than those without diabetes mellitus. DM has been shown to double the likelihood of requiring a second or contralateral amputation.[1,9]
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