Risk factors associated with mortality in veteran population following transtibial or transfemoral amputation
Risk factors associated with mortality in veteran population following transtibial or transfemoral amputation
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DOI：
10.1682/jrrd.2006.03.0030
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发表时间：
2006-11-01
影响因子：
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通讯作者：
Kwong, Pui L.
中科院分区：
文献类型：
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作者：
Bates, Barbara;Stineman, Margaret G.;Kwong, Pui L.
本研究探讨了与经股截肢、经胫骨截肢或髋关节离断后退伍军人死亡率相关的医疗条件。我们应用逻辑回归模型来确定与术后死亡率相关的临床因素。参与者包括2002年10月1日至2003年9月30日期间从退伍军人健康管理局医院出院的下肢截肢患者（n = 2，375）。大多数（98.9%）为男性。我们测量了累积住院、3个月和1年死亡率。结果是180例住院死亡，368例在术后3个月死亡，634例在术后1年截肢。围手术期全身性脓毒症患者（比值比= 4.28，95%置信区间= 2.87-6.39）的院内死亡率可能增加4倍以上。充血性心力衰竭、肾衰竭和肝脏疾病与所有时间段的死亡率显著相关。转移性癌症仅在3个月和1年时相关。我们的结论是，高医疗复杂性和死亡率证明了在急性期后康复期间需要仔细的医疗监督。
This study explored medical conditions associated with mortality among veterans following transfemoral amputation, transtibial amputation, or hip disarticulation. We applied logistic regression models to identify clinical factors associated with mortality postoperatively. The participants included patients with lower-limb amputations (n = 2,375) who were discharged from Veterans Health Administration hospitals between October 1, 2002, and September 30, 2003. Most (98.9%) were male. We measured cumulative in-hospital, 3 -month, and 1-year mortality. The results were 180 in-hospital deaths, 368 by 3 months, and 634 by the 1-year postsurgical amputation date. Those who had perioperative systemic sepsis (odds ratio = 4.28, 95% confidence interval = 2.87-6.39) had more than a fourfold increased likelihood of in-hospital mortality. Congestive heart failure, renal failure, and liver disease were significantly associated with mortality at all time periods. Metastatic cancer was associated only at 3 months and 1 year. We concluded that high medical complexity and mortality rates attest to the need for careful medical oversight during the postacute rehabilitation period.