Characterization of a Portuguese Major Amputee Population: 5 Years of a Physical and Rehabilitation Medicine Amputee Unit
DOI:
https://doi.org/10.25759/spmfr.487Keywords:
Amputees/rehabilitation, Amputation, Surgical, Amputation, Traumatic, Artificial Limbs, Portugal, Rehabilitation CentersAbstract
Introduction: Knowledge of the amputee population is relevant for health care planning, namely rehabilitation services and demand for prosthetic devices. In Portugal, there is not enough knowledge concerning these data. We aim to characterize a sample of five-year cases from an Amputee Physical and Rehabilitation Medicine Unit of a Portuguese Tertiary Hospital.Methods: All records from 2015-2020, were reviewed. Only major limb amputees were included. Descriptive and subgroup analysis was performed.
Results: From 737 patients, 620 were included. The majority (69%) were men, with an average age of 55.5 ± 20.5 years at the time of their first major amputation. Amputation level wasJtranstibial (TT) in 53%, transfemoral (TF) in 43%, with hip disarticulation, transradial, transhumeral and shoulder disarticulation ranging from 0:2% - 1.6%. The most common causes were dysvascular (64%) and traumatic (18%). Four out of 5 hip disarticulations were due to malignancy. JMore than half (54%) of vascular amputees were followed in the Diabetic Foot Clinic. The major re-amputation rate was 14%, including proximal and contralateral [10% for TF, 16% for TP]. The time between first major amputation and re-amputation was 1.6 ± 2.4 years.J Overall mortality was 24%: 38% of deaths occurred in the first year and 76% in 5-years. Considering only vascular causes, mortality rose to 33% and re-amputation in first year was 20%. Prosthetics attribution rates were 77%-90% for unilateral lower limb (LL) amputees and 73% for upper limb amputees. Bilateral LL amputees (n=70) were BiTF, BiTT and TF+TT, with 5%, 84% and 63% prosthetics rates, respectively. Traumatic amputations had the highest prosthetics rate (96%). In total, 78 patients did not fulfill the criteria to initiate prothetization, among the stated reasons were bilateral amputation, balance or contralateral limb alterations and neurologic disturbances.
Conclusion: We managed to achieve a characterization of a large case series of an Amputee population followed in a PRM Unit of a Portuguese Universitary General Hospital, focusing on the cause, level of amputation, re-amputation, prosthetics and mortality rates. This sample may contribute to a better knowledge of our amputee population, allowing for an improved approach to their medical care process and consequently a better-quality Amputee Rehabilitation.
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