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合并症对澳大利亚和新西兰非创伤性下肢截肢术后住院康复结局的影响。

Effect of comorbidities on inpatient rehabilitation outcomes following non-traumatic lower limb amputations in Australia and New Zealand.

作者信息

Archer Jack Peter, Capell Jacquelin, Mullan Judy, Alexander Tara

机构信息

Wagga Wagga Base Hospital, 38 Spring Street, Wagga Wagga, NSW 2650, Australia.

Australasian Rehabilitation Outcomes Centre (AROC), Australian Health Services Research Institute (AHSRI), University of Wollongong (UOW), Wollongong, NSW, Australia.

出版信息

Aust Health Rev. 2022 Oct;46(5):613-620. doi: 10.1071/AH21305.

Abstract

Background Non-traumatic lower limb amputation rates are rising worldwide, resulting in increased hospitalisations and use of rehabilitation services. This study aimed to identify key comorbidities associated with prolonged length of stay or decreased functional gain for episodes receiving inpatient rehabilitation following non-traumatic lower limb amputation. Methods Prospectively collected data submitted to the Australasian Rehabilitation Outcomes Centre were analysed. The cohort comprised episodes for patients (aged ≥18 years) discharged from inpatient rehabilitation between 1 July 2013 and 30 June 2018 following a non-traumatic lower limb amputation. Results The cohort included 5074 episodes with an average age of 66.3 years and the majority being male (71.7%). Comorbidities affecting the ability to participate in rehabilitation were reported for 65.4% of episodes, most commonly diabetes mellitus (50.3%), cardiac disease (33.5%), and respiratory disease (10.1%). These comorbidities were associated with a prolonged length of stay and reduced functional improvement. Conclusion This study showed comorbidities contribute to prolonged length of stay and poorer functional outcomes among those undergoing inpatient rehabilitation following non-traumatic lower limb amputation. Future research should focus on strategies to address these comorbidities to help improve patient outcomes and reduce healthcare costs.

摘要

背景

非创伤性下肢截肢率在全球范围内呈上升趋势,导致住院人数增加以及康复服务使用量上升。本研究旨在确定与非创伤性下肢截肢后接受住院康复治疗期间住院时间延长或功能改善降低相关的关键合并症。方法:对前瞻性收集并提交至澳大利亚和新西兰康复结局中心的数据进行分析。该队列包括2013年7月1日至2018年6月30日期间因非创伤性下肢截肢而从住院康复机构出院的患者(年龄≥18岁)的治疗记录。结果:该队列包括5074例治疗记录,平均年龄为66.3岁,大多数为男性(71.7%)。65.4%的治疗记录报告了影响参与康复能力的合并症,最常见的是糖尿病(50.3%)、心脏病(33.5%)和呼吸系统疾病(10.1%)。这些合并症与住院时间延长和功能改善降低相关。结论:本研究表明,合并症会导致非创伤性下肢截肢后接受住院康复治疗的患者住院时间延长且功能结局较差。未来的研究应侧重于解决这些合并症的策略,以帮助改善患者结局并降低医疗成本。

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