Trends in rehabilitation after amputation for geriatric patients with vascular disease

Implications for future health resource allocation

Dade D. Fletcher, Karen L. Andrews, John W. Hallett, Matthew A. Butters, Charles M. Rowland, Steven J. Jacobsen

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Objective: To assess the effect of demographic changes on rehabilitation of geriatric patients after amputation and the implications for future health resource allocation. Design: Population-based study. Setting: Olmsted County, MN. Participants: Residents over the age of 65 years who had a major lower-extremity amputation because of peripheral arterial disease between 1956 and 1995. Patients who had amputations between 1956 and 1973 (earlier cohort) were compared with those who had amputations between 1974 and 1995 (later cohort). Interventions: Not applicable. Main Outcome Measures: Demographic and clinical features, total number of amputations, amputation rates, and rate of successful prosthetic fitting over time. cl-Results: Of 292 patients, 93 had amputations between 1956 and 1973 and 199 between 1974 and 1995. Amputation rates declined after 1985, but the total number of amputations was unchanged. Patients in the later cohort were more likely to have a below-knee amputation (P<.001) and cerebrovascular disease (P=.008) and to be discharged to a nursing home (P<.001). There was no significant difference in median age at amputation, survival, or rates of successful prosthetic fitting over time. Conclusion: Although amputation rates have declined, the total number of amputations has increased. The rate of successful prosthetic fitting in the geriatric population has not changed significantly over 40 years. Amputations in the geriatric population in the United States will probably double from 28,000 to 58,000 per year by 2030, requiring considerable resources.

Original languageEnglish (US)
Pages (from-to)1389-1393
Number of pages5
JournalArchives of Physical Medicine and Rehabilitation
Volume83
Issue number10
DOIs
StatePublished - Oct 1 2002

Fingerprint

Resource Allocation
Health Resources
Vascular Diseases
Amputation
Geriatrics
Rehabilitation
Demography
Population
Cerebrovascular Disorders
Peripheral Arterial Disease
Nursing Homes
Lower Extremity
Knee

Keywords

  • Amputees
  • Arterial occlusive diseases
  • Geriatrics
  • Prostheses and implants
  • Rehabilitation
  • Treatment outcome

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Trends in rehabilitation after amputation for geriatric patients with vascular disease : Implications for future health resource allocation. / Fletcher, Dade D.; Andrews, Karen L.; Hallett, John W.; Butters, Matthew A.; Rowland, Charles M.; Jacobsen, Steven J.

In: Archives of Physical Medicine and Rehabilitation, Vol. 83, No. 10, 01.10.2002, p. 1389-1393.

Research output: Contribution to journalArticle

Fletcher, Dade D. ; Andrews, Karen L. ; Hallett, John W. ; Butters, Matthew A. ; Rowland, Charles M. ; Jacobsen, Steven J. / Trends in rehabilitation after amputation for geriatric patients with vascular disease : Implications for future health resource allocation. In: Archives of Physical Medicine and Rehabilitation. 2002 ; Vol. 83, No. 10. pp. 1389-1393.
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