VA Center for Limb Loss and Mobility (CLiMB), VA Puget Sound Health Care System, 1660 South Columbian Way, MS 151-R, Seattle, WA 98108, USA.
Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Box 359612, Seattle, WA 98104, USA.
Phys Med Rehabil Clin N Am. 2024 Nov;35(4):833-850. doi: 10.1016/j.pmr.2024.06.005. Epub 2024 Jul 23.
Most research on people undergoing lower limb amputations for dysvascular disease summarizes average patient outcome risks and average associations between patient factors and these outcomes. More recently, the importance of predicting patient-specific outcomes based on individual factors (ie, personalized rehabilitation) has become evident. This article reviews the evidence and discusses the importance of the following: (1) predicting outcomes to facilitate amputation-level and prosthesis prescription decisions and (2) how prediction models can be leveraged to develop decision support tools to facilitate provider/patient shared decision-making to ensure decisions considering each individual patient's priorities and preferences. Examples of these tools are discussed and referenced.
大多数针对因血管疾病而接受下肢截肢手术的患者的研究总结了患者总体结果风险,以及患者因素与这些结果之间的平均关联。最近,根据个体因素预测患者特定结果(即个性化康复)的重要性变得显而易见。本文回顾了相关证据,并讨论了以下方面的重要性:(1)预测结果,以方便截肢水平和义肢处方决策;(2)如何利用预测模型开发决策支持工具,以促进提供者/患者共同决策,确保决策考虑到每个患者的优先事项和偏好。本文讨论并引用了这些工具的示例。