Prior studies have identified age as a factor in determining an individual’s likelihood of receiving a prosthesis following a lower-limb amputation yet have been unable to account for other preamputation characteristics. In light of this, a team of researchers conducted a study to determine the effects of several preamputation characteristics on the probability of a patient receiving a prosthesis after a transfemoral amputation. The preamputation characteristics included age, gender, amputation etiology, year of amputation, mobility, cognitive ability, comorbidities, and time between surgery and the prosthesis decision. The researchers concluded that the effect of age, after controlling for confounders, still persists and is associated with the likelihood of being fit for a prosthesis.
This retrospective, population-based cohort study included 93 individuals over the age of 18 years who underwent a knee disarticulation or transfemoral amputation while residing in Olmsted County, Minnesota (2010 population: 144,248), between 1987 and 2013. Characteristics affecting the receipt of a prosthesis were analyzed using a logistic regression and a random forest algorithm for classification trees.
Among the participants, 24 received a prosthesis. The odds of receiving a prosthesis were almost 30 times higher in those able to walk independently prior to an amputation relative to those who could not walk independently. A ten-year increase in age was associated with a 53.8 percent decrease in the likelihood of being fit for a prosthesis. Time elapsed between surgery and the prosthesis decision was associated with a rise in probability of receiving a prosthesis for the first three months in the random forest algorithm. According to the authors, no other observed characteristics were associated with receipt of a prosthesis.
The study was published online December 12 in Physical Medicine and Rehabilitation.