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Bioelectric Analyses of an Osseointegrated Intelligent Implant Design System for Amputees

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Prosthetic fitting and mortality after major lower extremity amputation.

Nathaniel Forrester¹, Maja Wichhart Donzo¹, Chengcheng Hu²

¹Emory University School of Medicine, Atlanta, GA.

Journal of Vascular Surgery

|May 22, 2024

Summary

This summary is machine-generated.

Prosthetic fitting after major lower extremity amputation (LEA) significantly improves survival rates. This study found that prosthetic use is linked to a lower likelihood of mortality within 1 and 3 years post-surgery.

Keywords:

Amputation Amputees Functional status Health care Mortality Process assessment surgical

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Area of Science:

Orthopedics
Rehabilitation Medicine
Public Health

Background:

Major lower extremity amputation (LEA) is associated with high mortality and low ambulation rates.
While prosthetic fitting improves quality of life, its impact on post-LEA mortality remains unclear.
This study investigates the association between prosthetic fitting and mortality in a contemporary LEA cohort.

Purpose of the Study:

To determine if prosthetic fitting after major lower extremity amputation (LEA) is associated with reduced mortality.
To analyze survival outcomes in patients who received prosthetic fitting compared to those who did not.
To assess the predictive value of preoperative functional status on postoperative outcomes.

Main Methods:

Retrospective cohort study of 702 patients undergoing LEA between 2015-2022.
Exposure: prosthetic fitting post-LEA.
Primary outcomes: mortality at 1 and 3 years, analyzed using extended Cox models with time-dependent exposure.

Main Results:

46.6% of patients were fitted for a prosthetic.
Prosthetic fitting was associated with significantly decreased mortality risk at 1 year (aHR 0.24) and 3 years (aHR 0.40).
Preoperative non-ambulatory status did not preclude eventual postoperative ambulation in a notable percentage of patients.

Conclusions:

Prosthetic fitting is strongly associated with improved long-term survival after LEA.
Preoperative functional status is not always indicative of postoperative functional outcomes.
Optimizing prosthetic fitting and rehabilitation pathways is crucial for enhancing survival in LEA patients.