American journal of surgery · 2020
Outcomes of major lower extremity amputations n dysvascular patients: Room for improvement.
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O'Banion Leigh Ann, Dirks Rachel, Farooqui Emaad, Kaups Krista, Qumsiyeh Yazen, Rome Cambia, Davis James
Аннотация
OBJECTIVES: Dysvascular patients account for >80% of major amputations in the US. We sought to determine if early mobilization and discharge disposition decreased post-operative hospital length of stay (PO-LOS) and expedited independent ambulation.
METHODS: A retrospective review of dysvascular patients undergoing major amputations was performed. Primary outcomes included PO-LOS, discharge disposition, and days to ambulation.
RESULTS: 130 patients were included. Patients evaluated by Physical Therapy (PT) within 1 day of formal amputation had decreased PO-LOS (5.6 vs 6.5 days, p = 0.029). Patients discharged to rehab had a shorter PO-LOS (4 days) than those discharged to SNF or home (8 and 5 days, respectively; p = 0.008). Time to ambulation was shorter for patients discharged to rehab (109 days vs home = 153 days; SNF = 175 days; p = 0.033).
CONCLUSION: Modifiable factors, including early PT and rehab placement, decreased PO-LOS and expedited time to ambulation. A need exists for a standardized multidisciplinary team approach to improve outcomes.
METHODS: A retrospective review of dysvascular patients undergoing major amputations was performed. Primary outcomes included PO-LOS, discharge disposition, and days to ambulation.
RESULTS: 130 patients were included. Patients evaluated by Physical Therapy (PT) within 1 day of formal amputation had decreased PO-LOS (5.6 vs 6.5 days, p = 0.029). Patients discharged to rehab had a shorter PO-LOS (4 days) than those discharged to SNF or home (8 and 5 days, respectively; p = 0.008). Time to ambulation was shorter for patients discharged to rehab (109 days vs home = 153 days; SNF = 175 days; p = 0.033).
CONCLUSION: Modifiable factors, including early PT and rehab placement, decreased PO-LOS and expedited time to ambulation. A need exists for a standardized multidisciplinary team approach to improve outcomes.