Identifying Variables Associated with Long-Term Quality of Life after Severe Lower Limb Trauma Using the LIMB-Q.

Abstract

Severe lower limb trauma has a substantial impact on health-related quality of life. In some cases, severity of the trauma necessitates a decision between reconstruction and amputation. The aim of this study was to identify variables associated with long-term quality of life using the LIMB-Q and to compare outcomes between patients undergoing amputation versus those receiving reconstructive surgery. This retrospective, cross-sectional study, conducted at 2 Dutch health care institutions, involved patients with severe lower limb trauma who completed the LIMB-Q between February of 2020 and October of 2022. This study consisted of 87 patients divided into 2 groups: an amputation group (n = 32) and a reconstruction group (n = 55). The most common injury types were 3B/C crush injuries according to the Gustilo-Anderson classification. Clinical variables significantly associated with different LIMB-Q subdomain scores included age at trauma on function (P = 0.045), fracture-related infection on function (P = 0.009) and chronic pain on function, symptoms, and work (P = 0.009, P = 0.009, and P = 0.027, respectively). No significant long-term differences were found between the amputation and reconstruction groups. Age at trauma, fracture-related infection, and chronic pain were significantly associated with LIMB-Q subdomain scores in a group of 87 patients with severe lower limb trauma. Patients in the long-term amputation and reconstruction groups had similar LIMB-Q scores, underscoring the importance of personalized treatment choices. Risk, III.