Journal of Rehabilitation Research & Development (JRRD)

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Volume 52 Number 6, 2015
   Pages 641 — 652

Abstract — Predicting prosthetic prescription after major lower-limb amputation

Linda Resnik, PT, PhD, OCS;1–2* Matthew Borgia, AM1

1Providence Department of Veterans Affairs Medical Center, Providence, RI; 2Department of Health Services Policy and Practice, Brown University, Providence, RI

Abstract —  We describe prosthetic limb prescription in the first year following lower-limb amputation and examine the relationship between amputation level, geographic region, and prosthetic prescription. We analyzed 2005 to 2010 Department of Veterans Affairs (VA) Inpatient and Medical Encounters SAS data sets, Vital Status death data, and National Prosthetic Patient Database data for 9,994 Veterans who underwent lower-limb amputation at a VA hospital. Descriptive statistics and bivariates were examined. Cox proportional hazard models identified factors associated with prosthetic prescription. Analyses showed that amputation level was associated with prosthetic prescription. The hazard ratios (HRs) were 1.41 for ankle amputation and 0.46 for transfemoral amputation compared with transtibial amputation. HRs for geographic region were Northeast = 1.49, Upper Midwest = 1.26, and West = 1.39 compared with the South (p < 0.001). African American race, longer length of hospital stay, older age, congestive heart failure, paralysis, other neurological disease, renal failure, and admission from a nursing facility were negatively associated with prosthetic prescription. Being married was positively associated. After adjusting for patient characteristics, people with ankle amputation were most likely to be prescribed a prosthesis and people with transfemoral amputation were least likely. Geographic variation in prosthetic prescription exists in the VA and further research is needed to explain why.

Key words:amputation, amputee, assistive technology, limb loss, lower limb, prescription, prosthetics, regional variation, rehabilitation, Veteran.


View HTML ¦ View PDF ¦ Contents Vol. 52, No.6

This article and any supplementary material should be cited as follows:
Resnik L, Borgia M. Predicting prosthetic prescription after major lower-limb amputation. J Rehabil Res Dev. 2015;52(6):641–52.
http://dx.doi.org/10.1682/JRRD.2014.09.0216
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