Abstract
Pezzin LE, Dillingham TR, MacKenzie EJ. Rehabilitation and the long-term outcomes
of persons with trauma-related amputations. Arch Phys Med Rehabil 2000;81:292-300.
Objective: To examine the long-term outcomes of persons undergoing trauma-related amputations,
and to explore factors affecting their physical, social, and mental health and the
role of inpatient rehabilitation in improving such outcomes. Design: Abstracted medical records and interview data sought for a retrospective cohort of
persons who had undergone a lower-limb trauma-related amputation. Participants: Patients identified with a principal or secondary diagnosis of a trauma-related amputation
to the lower extremity at the University of Maryland Shock Trauma Center between 1984
and 1994. Patients with spinal cord injury or traumatic brain injury were excluded.
Results: Of 146 patients who had trauma-related amputations to the lower limb at the University
of Maryland Shock Trauma Center during the study period, nearly 9% died during the
acute admission and 3.5% died after discharge. About 87% of all trauma-related amputations
involved males, and roughly three quarters involved white persons. About 80% of all
amputations occurred before age 40. The health profile of traumatic amputee subjects
interviewed in the study (n = 78, 68% response rate) was systematically lower than that of the general US population
for all SF-36 scores. The differences in profiles were largest among SF-36 scales
sensitive to differences in physical health status, particularly physical functioning,
role limitations due to physical health, and bodily pain. About one fourth of persons
with a trauma-related amputation reported ongoing severe problems with the residual
limb, including phantom pain, wounds, and sores. The number of inpatient rehabilitation
nights significantly improved the ability of patients with amputation to function
in their physical roles, increased vitality, and reduced bodily pain. Inpatient rehabilitation
was also significantly correlated with improved vocational outcomes. Conclusions: These findings suggest a substantial effect of inpatient rehabilitation in improving
long-term outcomes of persons with trauma-related amputations. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy
of Physical Medicine and Rehabilitation
Keywords
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Article info
Publication history
Accepted:
September 12,
1999
Received:
August 11,
1999
Footnotes
☆Supported by grant R49/CCR302486 from the Centers for Disease Control and Prevention.
☆☆The views expressed in this paper are those of the authors. No official endorsement by the Centers for Disease Control and Prevention or the Department of Health and Human Services is implied or should be inferred.
★No commercial party having a direct financial interest in the result of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
★★Reprint requests to Liliana E. Pezzin, PhD, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 6-100, Baltimore, MD 21205.
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© 2000 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
