Hebert Jackie S, Ashworth Nigel L
Division of Physical Medicine and Rehabilitation, University of Alberta, Glenrose Rehabilitation Hospital Site, 10230 - 111 Avenue, Edmonton, Alberta, Canada, T5G 0B7.
Disabil Rehabil. 2006 May 30;28(10):613-8. doi: 10.1080/09638280500265219.
To determine factors predictive of return to work (RTW) and days of total disability (TD) in a population of persons working at the time of lower extremity amputation.
Retrospective chart and database review.
Of 88 valid cases, 48% involved toe amputation, 23% transtibial, 14% partial foot, 14% transfemoral, and 2% high level. Fifty-eight percent of all subjects RTW, 19% were deemed 'fit for work', and 23% did not RTW. Days TD ranged from 0 to 1664, with a mean of 366 days. Toe amputation level showed a mean of 127 days of TD. Bivariate analysis showed amputation level, total costs to Workers Compensation Board (WCB), and days TD significantly related to RTW, and rehabilitation costs, vocational rehabilitation, work assessment, age, number of surgical procedures, number of days in acute care, and amputation level significantly related to days TD. In the multivariate model, only amputation level and higher gross annual income showed predictive value for RTW. However older age, more surgical procedures, less days in hospital, and higher amputation levels were all predictive of increased days TD.
Toe amputation level had a surprisingly high number of days TD, which may have significant potential economic and disability impact on the workplace. Other factors beyond simply amputation level (such as previous income level) are important considerations for RTW.
确定下肢截肢时在职人群中预测重返工作岗位（RTW）和全残天数（TD）的因素。
回顾性病历和数据库审查。
在88例有效病例中，48%为趾截肢，23%为经胫骨截肢，14%为部分足截肢，14%为经股骨截肢，2%为高位截肢。所有受试者中有58%重返工作岗位，19%被认为“适合工作”，23%未重返工作岗位。全残天数从0天到1664天不等，平均为366天。趾截肢水平的全残天数平均为127天。双变量分析显示截肢水平、向工人赔偿委员会（WCB）支付的总费用和全残天数与重返工作岗位显著相关，而康复费用、职业康复、工作评估、年龄、手术程序数量、急性护理天数和截肢水平与全残天数显著相关。在多变量模型中，只有截肢水平和较高的年总收入对重返工作岗位具有预测价值。然而，年龄较大、手术程序较多、住院天数较少和截肢水平较高均预测全残天数增加。
趾截肢水平的全残天数出奇地高，这可能对工作场所产生重大的潜在经济和残疾影响。除了截肢水平（如以前的收入水平）之外的其他因素是重返工作岗位的重要考虑因素。
