Health Related Quality of Life Outcomes after Lower Extremity Amputation

Area of Science:

• Orthopedics
• Vascular Surgery
• Rehabilitation Medicine

Background:

• Lower limb amputation significantly impacts patients' health related quality of life (HRQoL).
• Comparative data on HRQoL across different indications and amputation levels are limited.
• Understanding factors influencing HRQoL is crucial for optimizing patient care.

Purpose of the Study:

• To evaluate EQ-5D-3L outcomes in patients undergoing major versus minor lower extremity amputations.
• To compare HRQoL between patients with and without ischemia.
• To identify predictors of EQ-5D index scores in lower limb amputees.

Main Methods:

• Retrospective cohort study at a German level 1 trauma center (2010-2020).
• Patients classified by indication (ischemia vs. trauma/tumor/infection) and amputation level (major vs. minor).
• EQ-5D-3L interviews assessed HRQoL; multivariable linear regression identified predictors.

Main Results:

• Mobility limitations were more frequent in major amputations across both ischemic and non-ischemic groups.
• Pain/discomfort was higher in major amputations, particularly in ischemic patients.
• In ischemic patients, higher American Society of Anesthesiologists (ASA) score predicted lower EQ-5D; amputation level did not.
• In non-ischemic patients, coronary heart disease and major amputation were negative predictors of EQ-5D.

Conclusions:

• HRQoL impairments post-amputation are influenced by indication and level.
• Comorbidity burden, especially ASA score and coronary disease, has a greater impact than amputation level alone.
• Multidisciplinary optimization of systemic health is recommended in amputation care.