Hordacre Brenton G, Stevermuer Tara, Simmonds Frances, Crotty Maria, Eagar Kathy
Department of Rehabilitation, Aged and Extended Care, Flinders University, Repatriation General Hospital, Daws Road, Daw Park, SA 5041, Australia.
Aust Health Rev. 2013 Feb;37(1):41-7. doi: 10.1071/AH11138.
Examine demographics, clinical characteristics and rehabilitation outcomes of lower-limb amputees, using the Australasian Rehabilitation Outcomes Centre (AROC) database.
Lower-limb amputee rehabilitation separations between 2004 and 2010 were identified using AROC impairment codes 5.3-5.7.(1) Analysis was conducted by year, impairment code, Australian National Sub-acute and Non-Acute Patient (AN-SNAP) classification (S2-224, Functional Independence Measure (FIM) motor(Mot) score 72-91; S2-225, FIM (Mot) score 14-71) and states of Australia.
Mean length of stay (LOS) for all lower-limb amputee episodes was 36.1 days (95% confidence interval (CI): 35.4-36.9). Majority of episodes were unilateral below knee (63.6%), males (71.8%) with a mean age of 67.9 years (95% CI: 67.6-68.3). Year-on-year analysis revealed a trend for increasing LOS and decreasing age. Analysis by impairment code demonstrated no significant difference in rehabilitation outcomes. Analysis by AN-SNAP found that LOS was 16.2 days longer for S2-225 than for S2-224 (95% CI: 14.7-17.8, P<0.001), and FIM (Mot) change was 12.0 points higher for S2-225 than for S2-224 (95% CI: 11.5-12.6, P<0.001). Analysis by states revealed significant variation in LOS, FIM (Mot) change and FIM (Mot) efficiency which may be associated with variations in organisation of rehabilitation services across states.
Although amputees represented a comparatively small proportion of all rehabilitation episodes in Australia, their LOS was significant. Unlike many other rehabilitation conditions, there was no evidence of decreasing LOS over time. AN-SNAP classes were effective in distinguishing rehabilitation outcomes, and could potentially be used more effectively in planning rehabilitation programs.
利用澳大拉西亚康复结局中心（AROC）数据库，研究下肢截肢者的人口统计学特征、临床特点及康复结局。
使用AROC损伤编码5.3 - 5.7识别2004年至2010年间下肢截肢者的康复出院情况。（1）按年份、损伤编码、澳大利亚国家亚急性和非急性患者（AN - SNAP）分类（S2 - 224，功能独立性测量（FIM）运动（Mot）评分72 - 91；S2 - 225，FIM（Mot）评分14 - 71）以及澳大利亚各州进行分析。
所有下肢截肢病例的平均住院时间（LOS）为36.1天（95%置信区间（CI）：35.4 - 36.9）。大多数病例为单侧膝下截肢（63.6%），男性占71.8%，平均年龄67.9岁（95% CI：67.6 - 68.3）。逐年分析显示LOS呈上升趋势，年龄呈下降趋势。按损伤编码分析显示康复结局无显著差异。按AN - SNAP分析发现，S2 - 225的LOS比S2 - 224长16.2天（95% CI：14.7 - 17.8，P < 0.001），S2 - 225的FIM（Mot）变化比S2 - 224高12.0分（95% CI：11.5 - 12.6，P < 0.001）。按州分析显示LOS、FIM（Mot）变化和FIM（Mot）效率存在显著差异，这可能与各州康复服务组织的差异有关。
尽管截肢者在澳大利亚所有康复病例中占比相对较小，但其LOS较长。与许多其他康复情况不同，没有证据表明LOS随时间减少。AN - SNAP分类在区分康复结局方面有效，并且有可能在康复项目规划中更有效地使用。
