A study analyzed ambulatory rates and risk factors for non-ambulation in patients undergoing a major lower-limb amputation and concluded that most patients who could walk independently or with an assistive aid prior to amputation were able to remain ambulatory, and patients who could not walk six months after their amputation failed to resume ambulating.
Researchers conducted a retrospective review of 811 patients who underwent transtibial or transfemoral amputations at Montefiore Medical Center, Bronx, New York, between January 2009 and December 2014. Demographic information and comorbid conditions, including the patients’ functional status prior to surgery, at six months after surgery, and at the latest follow-up was recorded. Following exclusion criteria, 538 patients were included. Patients who were either independent or used an assistive device were considered ambulatory, while those who were completely wheelchair-dependent or bedbound were considered non-ambulatory.
Preoperatively, 83.1 percent of transtibial patients were ambulatory as were 44.9 percent of transfemoral patients. At six-month follow up, the percentages dropped to 58 percent and 25.2 percent, respectively, for all patients.
For patients who were ambulatory pre-operatively, 73.9 percent of transtibial amputees and 62.7 percent of transfemoral amputees remained so post-operatively. Of those patients, there was no change in ambulatory status between their six-month and greater than one-year follow-ups.
An age greater than 70 years and female sex were associated with post-operative non-ambulation. None of the comorbid conditions recorded (diabetes, renal insufficiency, end stage renal disease, peripheral vascular disease, or body mass index greater than 35) was found to have a statistically significant correlation with post-operative ambulation using multivariable analysis.
The study, Ambulatory Status Following Major Lower Extremity Amputation, was published in Annals of Vascular Surgery.
