Chamlian Therezinha Rosane
Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2014 Oct-Dec;12(4):440-6. doi: 10.1590/S1679-45082014AO3132.
To evaluate the indication of prosthesis during rehabilitation and the maintenance of their use or abandonment rate after discharge, as well as mortality of lower limb amputees due to peripheral arterial disease.
A retrospective and cross-sectional study carried out with lower limb amputee patients, at transfemoral and transtibial levels, due to vascular conditions. The sample was composed of 310 patients (205 men, 105 women, mean age 61.8 years), transfemoral (142) and transtibial (150) levels, unilateral or bilateral (18). A total of 217 were fitted with prosthesis and 93 did not. Nonparametric statistical tests with equality of two proportions, 95% confidence interval and p value <0,05 were used.
Out of 195 patients we contacted, 151 were fitted with prosthesis and 44 not. Of those that were fitted with prosthesis, 54 still use it, 80 abandoned and 17 died. In the group without prosthesis, 27 were on wheelchair and 17 died. Mortality is statistically higher among patients who were not fitted with prosthesis and 34 death occur, on average, 3.91 years after amputation. Survival time of patients who were not fitted with prosthesis was smaller than those were fitted.
The use of prosthesis in lower limb amputees, due to vascular conditions, during rehabilitation is high. However, maintenance of prosthesis is not frequent after discharge. Early and high mortality is observed mainly among diabetic patients.
评估康复期间假肢的适应证、出院后其使用的维持情况或弃用率,以及下肢截肢患者因外周动脉疾病导致的死亡率。
对因血管疾病行下肢截肢(经股骨和经胫骨水平)的患者进行一项回顾性横断面研究。样本由310例患者组成(205例男性,105例女性,平均年龄61.8岁),经股骨水平截肢142例,经胫骨水平截肢150例,单侧或双侧截肢18例。共有217例患者安装了假肢,93例未安装。采用两个比例相等的非参数统计检验、95%置信区间和p值<0.05。
在我们联系的195例患者中,151例安装了假肢,44例未安装。在安装了假肢的患者中,54例仍在使用,80例弃用,17例死亡。在未安装假肢的组中,27例使用轮椅,17例死亡。未安装假肢的患者死亡率在统计学上更高,平均34例死亡发生在截肢后3.91年。未安装假肢患者的生存时间短于安装假肢的患者。
因血管疾病行下肢截肢患者在康复期间假肢使用率较高。然而,出院后假肢维持使用并不常见。主要在糖尿病患者中观察到早期高死亡率。