Schoppen Tanneke, Boonstra Annemarijke, Groothoff Johan W, de Vries Jaap, Göeken Ludwig N, Eisma Willem H
Department of Rehabilitation Medicine, University Hospital Groningen, The Netherlands.
Arch Phys Med Rehabil. 2003 Jun;84(6):803-11. doi: 10.1016/s0003-9993(02)04952-3.
To study the value of physical, mental, and social characteristics as predictors of functional outcome of elderly amputees.
Prospective, inception cohort study; comparisons with reference populations.
Main hospitals, rehabilitation centers, nursing homes, patients' own residence settings in 1 of the 3 northern provinces in the Netherlands.
Forty-six patients older than 60 years, with unilateral transtibial or transfemoral amputation or knee disarticulation because of vascular disease.
Measurement of physical, mental, and social predictors 2 and 6 weeks postamputation.
The Sickness Impact Profile (SIP-68), Groningen Activity Restriction Scale (GARS), Timed up and go (TUG) test, and prosthetic use.
A total of 15% of amputees died within the first year after amputation. Seventy percent lived independently at home 1 year postamputation. The functional level of the patients was low, as shown by high scores on the SIP-68 (mean, 23.6), GARS (mean, 41.2), and TUG test (mean, 23.9s). Functionally effective prosthetic use, as measured with the classification of Narang and Pohjolainen, was reached by 49%. For the SIP-68 scores, age, comorbidity, 1-leg balance, and the 15-word test predicted functional outcome in 69% of amputees. For the GARS score, age, 1-leg balance, and the 15-word test predicted functional outcome in 64%. For the TUG test, age and 1-leg balance predicted functional outcome in 42% of amputees. After correction for age, the only significant predictor for prosthetic use was 1-leg balance.
Elderly patients with a leg amputation had a low functional level 1-year postamputation. An important part of functional outcome could be predicted 2 weeks after amputation by age at amputation, 1-leg balance on the unaffected limb, and cognitive impairment. Severe comorbidity probably also played a role. The results may be used in the general policy concerning leg amputees.
研究身体、心理和社会特征作为老年截肢者功能结局预测指标的价值。
前瞻性起始队列研究；与参考人群进行比较。
荷兰北部三省之一的主要医院、康复中心、养老院及患者家中。
46名60岁以上因血管疾病行单侧经胫骨或经股骨截肢或膝关节离断术的患者。
截肢后2周和6周测量身体、心理和社会预测指标。
疾病影响量表（SIP - 68）、格罗宁根活动受限量表（GARS）、定时起立行走测试（TUG）及假肢使用情况。
截肢后第一年内共有15%的截肢者死亡。截肢1年后70%的患者独立居家生活。患者功能水平较低，SIP - 68（平均23.6）、GARS（平均41.2）及TUG测试（平均23.9秒）得分较高即表明了这一点。根据纳朗和波约拉伊宁的分类方法，49%的患者实现了有效的假肢使用。对于SIP - 68评分，年龄、合并症、单腿平衡及15字测试可预测69%截肢者的功能结局。对于GARS评分，年龄、单腿平衡及15字测试可预测64%截肢者的功能结局。对于TUG测试，年龄和单腿平衡可预测42%截肢者的功能结局。校正年龄后，假肢使用的唯一显著预测指标是单腿平衡。
老年腿部截肢患者截肢1年后功能水平较低。截肢后2周，截肢时的年龄、未受影响肢体的单腿平衡及认知障碍可预测功能结局的重要部分。严重合并症可能也起了作用。这些结果可用于有关腿部截肢者的总体政策。
