Abstract
Although there is strong evidence to show that the risk of dying after transtibial
amputation is higher than partial foot amputation, we are concerned by the implication
that amputation level influences mortality, and that such interpretations of the evidence
may be used to inform decisions about the choice of amputation level. We argue that
the choice of partial foot or transtibial amputation does not influence the risk of
mortality. The highest mortality rates are observed in studies with older people with
more advanced systemic disease and multiple comorbidities. Studies that control for
the confounding influence of these factors have shown no differences in mortality
rates by amputation level. These insights have important implications in terms of
how we help inform difficult decisions about amputation at either the partial foot
or transtibial level, given a more thoughtful interpretation of the published mortality
rates.
Graphical abstract
Graphical Abstract
Keywords
List of abbreviations:
PFA (partial foot amputation), RR (relative risk), TTA (transtibial amputation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 24, 2017
Footnotes
Presented to the American Orthotic and Prosthetic Association, September 8–11, 2016, Boston, MA.
Supported by the American Orthotic and Prosthetic Association (grant no. RFP-04012015).
The funding body did not have any role in the design of the protocol, writing of the manuscript, or the decision to submit for publication.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
