Long-term outcomes and survival of patients with bilateral transtibial amputations after rehabilitation.

Abstract

To examine long-term outcomes and survival of patients after bilateral transtibial amputation (BTTA). A retrospective chart review and a cross-sectional interview was conducted at Amputee Rehabilitation Service, West Park Healthcare Centre, Toronto, Canada, with consecutive diabetic or vascular BTTA patients (n = 82) admitted for rehabilitation from 1998 to 2003. Main outcome measures included the Houghton scale of prosthetic use, SF-12, Frenchay Activities Index, and qualitative measurement of activities of daily living (ADL). Of 82 patients admitted for BTTA rehabilitation, 34 patients were interviewed an average of 3.7 yrs after amputation. Another 32 patients had died. Life expectancy was 4.2 yrs beyond rehabilitation discharge (Kaplan-Meier survival analysis). The mean modified Houghton score at telephone follow-up was 6.3 (maximum score of 9), with a significant improvement from rehabilitation discharge to follow-up (P = 0.001). Eighty-five percent were still wearing prostheses regularly and were walking. Most remained independent in ADLs. Patients undergoing rehabilitation for BTTA continue to do well at long-term follow-up and to survive, on average, for more than 4 yrs after discharge. Therefore, they should be given strong consideration for prosthetic fitting.