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• W1965840315 abstract "<h3>Backgound</h3> Survival implications of achieving different grades of physical independence after lower extremity amputation are unknown. <h3>Objectives</h3> To identify thresholds of physical independence achievement associated with improved 6-month survival and to identify and compare other risk factors after removing the influence of the grade achieved. <h3>Design</h3> Data were combined from 8 administrative databases. Grade was measured on the basis of 13 individual self-care and mobility activities measured at inpatient rehabilitation discharge. <h3>Setting</h3> Ninety-nine US Department of Veterans Affairs Medical Centers. <h3>Patients</h3> Retrospective longitudinal cohort study of 2616 veterans who underwent lower extremity amputation and subsequent inpatient rehabilitation between October 1, 2002, and September 30, 2004. <h3>Main Outcome Measure</h3> Cumulative 6-month survival after rehabilitation discharge. <h3>Results</h3> The 6-month survival rate (95% confidence interval [CI]) for those at grade 1 (total assistance) was 73.5% (70.5%-76.2%). The achievement of grade 2 (maximal assistance) led to the largest incremental improvement in prognosis with survival increasing to 91.1% (95% CI, 85.6%-94.5%). In amputees who remained at grade 1, the 30-day hazards ratio for survival compared with grade 6 (independent) was 43.9 (95% CI, 10.8-278.2), sharply decreasing with time. Whereas metastatic cancer and hemodialysis remained significantly associated with reduced survival (both<i>P</i> ≤ .001), anatomical amputation level was not significant when rehabilitation discharge grade and other diagnostic conditions were considered. <h3>Conclusions</h3> Even a small improvement to grade 2 in the most severely impaired amputees resulted in better 6-month survival. Health care systems must plan appropriate interdisciplinary treatment strategies for both medical and functional issues after amputation." @default.
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• W1965840315 date "2009-06-15" @default.
• W1965840315 modified "2023-10-18" @default.
• W1965840315 title "Survival Analysis in Amputees Based on Physical Independence Grade Achievement" @default.
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• W1965840315 doi "https://doi.org/10.1001/archsurg.2009.37" @default.
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