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Does obesity predict functional outcome in the dysvascular amputee?
Corey A Kalbaugh1, Spence M Taylor, Brooke A Kalbaugh
1Academic Department of Surgery, Section of Vascular Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina 29605, USA.
The American Surgeon
|August 18, 2006
Summary
Obesity does not negatively impact functional outcomes for patients undergoing lower limb amputation due to peripheral arterial disease (PAD). Body mass index (BMI) was not a significant predictor of prosthetic use, ambulation, survival, or independence in this patient group.
Area of Science:
- Vascular Surgery
- Orthopedics
- Rehabilitation Medicine
Background:
- Peripheral arterial disease (PAD) frequently necessitates lower limb amputation.
- The impact of obesity on functional outcomes post-amputation for PAD patients is not well-established.
- Understanding predictors of functional recovery is crucial for optimizing patient care.
Purpose of the Study:
- To investigate the predictive value of body mass index (BMI) on functional outcomes in patients with dysvascular amputations.
- To determine if obesity is associated with poorer outcomes in major lower limb amputations secondary to PAD.
Main Methods:
- Analysis of 434 patients undergoing major lower limb amputation for PAD.
- Classification of patients into BMI categories: underweight, normal, overweight, and obese.
- Assessment of outcomes including prosthetic usage, ambulation, survival, and independent living status.
- Statistical analysis using chi-squared tests, Kaplan-Meier curves, and multivariate regression models.
Main Results:
- Overall prosthetic usage was 48.6%, 36-month ambulation 42.8%, survival 48.1%, and independent living 72.3%.
- No statistically significant differences in outcomes were observed between normal, overweight, and obese patients.
- Underweight patients showed significantly poorer prosthetic usage and ambulation compared to other groups.
- Multivariate analysis indicated BMI was not an independent predictor of functional outcomes after adjusting for comorbidities and amputation level.
Conclusions:
- Body mass index (BMI) did not correlate with functional outcomes in patients undergoing major lower limb amputation for PAD.
- Obesity does not predict a poorer prognosis or functional outcome in this patient population.
- Underweight status, however, was associated with poorer prosthetic use and ambulation outcomes.