Archives of physical medicine and rehabilitation · 2026
Undernutrition Is Associated With Higher Rate of Reamputation or Mortality, Lower Mobility, and Lower Quality of Life After Dysvascular Major Lower Limb Amputation: A Longitudinal Observational Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kolen Aniek M, Krops Leonie A, Jager-Wittenaar Harriët, Dijkstra Martijn L, Keller B Paul J A, Oskam Jacques, Vierhout Bastiaan P, de Vries Jean-Paul P M, van Walraven Laurens, Krijnen Wim P, Dekker Rienk, Geertzen Jan H B
Аннотация
OBJECTIVE: To investigate the association between undernutrition and survival, reamputation-free survival, quality of life (QoL), wound healing, mobility, and work status postdysvascular major lower limb amputation (LLA).
DESIGN: Longitudinal observational multicenter study.
SETTING: At multiple settings, including hospitals, rehabilitation/care facilities, and at home.
PARTICIPANTS: Adults who have undergone dysvascular major LLA (N=81) in 2023, without severe malabsorption disease.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Participants' nutritional status (Patient-Generated Subjective Global Assessment) was assessed at <12 days, 5 weeks, 6 months, and 9 months post-LLA. Reamputation-free survival and QoL (World Health Organization Quality of Life Questionnaire-BREF) were assessed at 5 weeks, 6 months, and 9 months, wound healing at 5 weeks, mobility (K-level) at 6 and 9 months, and work status at 9 months post-LLA.
RESULTS: Eighty-one participants were included (mean age 69.7±10.5y; 73% men; 73% transtibial LLA). Participants who died (n=14) or required reamputation (n=4) were undernourished at <12 days post-LLA. Undernutrition was significantly associated with lower reamputation-free survival (χ2=3.976; P=.046) and lower physical and psychological QoL (B=-7.6; P=.003; B=-9.9; P<.001), but not with survival (χ2=2.637; P=.101) and impaired wound healing (OR, 1.88; P=.272). Undernutrition was significantly associated with lower mobility (K-level 0/1 vs 2/3/4; OR, 0.20; P=.035) at 6 months post-LLA, but not at 9 months (OR, 0.33; P=.303). Lower Patient-Generated Subjective Global Assessment score was significantly associated with longer survival and reamputation-free survival, and better QoL, higher mobility, and higher rates of employment/volunteering.
CONCLUSIONS: These findings highlight the relevance of undernutrition in the dysvascular major LLA population, and the critical need for nutritional interventions to prevent or limit undernutrition, with the potential to improve outcomes such as reamputation-free survival, QoL, and mobility.
DESIGN: Longitudinal observational multicenter study.
SETTING: At multiple settings, including hospitals, rehabilitation/care facilities, and at home.
PARTICIPANTS: Adults who have undergone dysvascular major LLA (N=81) in 2023, without severe malabsorption disease.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Participants' nutritional status (Patient-Generated Subjective Global Assessment) was assessed at <12 days, 5 weeks, 6 months, and 9 months post-LLA. Reamputation-free survival and QoL (World Health Organization Quality of Life Questionnaire-BREF) were assessed at 5 weeks, 6 months, and 9 months, wound healing at 5 weeks, mobility (K-level) at 6 and 9 months, and work status at 9 months post-LLA.
RESULTS: Eighty-one participants were included (mean age 69.7±10.5y; 73% men; 73% transtibial LLA). Participants who died (n=14) or required reamputation (n=4) were undernourished at <12 days post-LLA. Undernutrition was significantly associated with lower reamputation-free survival (χ2=3.976; P=.046) and lower physical and psychological QoL (B=-7.6; P=.003; B=-9.9; P<.001), but not with survival (χ2=2.637; P=.101) and impaired wound healing (OR, 1.88; P=.272). Undernutrition was significantly associated with lower mobility (K-level 0/1 vs 2/3/4; OR, 0.20; P=.035) at 6 months post-LLA, but not at 9 months (OR, 0.33; P=.303). Lower Patient-Generated Subjective Global Assessment score was significantly associated with longer survival and reamputation-free survival, and better QoL, higher mobility, and higher rates of employment/volunteering.
CONCLUSIONS: These findings highlight the relevance of undernutrition in the dysvascular major LLA population, and the critical need for nutritional interventions to prevent or limit undernutrition, with the potential to improve outcomes such as reamputation-free survival, QoL, and mobility.