"Successful outcome" after below-knee amputation: an objective definition and influence of clinical variables

摘要: Functional success after below-knee amputation (BKA) has been poorly studied. The purpose of this study was to establish a consistent definition "successful outcome" BKA and identify clinical variables influencing that definition. Three hundred nine consecutive patients undergoing were evaluated postoperatively using the following for outcome": 1) wound healing without need revision higher level; 2) maintenance ambulation with prosthesis at least 1 year or until death; 3) survival 6 months. Independent predictors outcome determined bivariate multivariable logistic regression analyses. For cohort, median 44 months 60 months, respectively. Although 86.4 per cent healed level, 63.4 maintained 86.1 survived successful as defined by attaining all three components definitions occurred in only 51.1 (n = 158) patients. Of 19 examined, six identified analysis significantly associated outcome. However, found be independent modeling. presence coronary artery disease [odds ratio (OR), 0.465; 95% CI, 0.289-0.747], cerebrovascular (OR, 0.389; 0.154-0.980), impaired ambulatory ability before 0.310; 0.154-0.623) each decreased odds Patients who presented combination another predictor had 20 23 probability 10.4 success. In contrast, none presentation 67.5 BKA. A standardized capable predicting outcomes is feasible can useful tool determine rehabilitation potential. When judged our definition, failure possess high potential rehabilitation, whereas multiple rarely rehabilitate, should probably receive palliative above-knee amputation, forgo expense futile prosthetic training.