TY - JOUR
T1 - Venous thromboembolism in a rehabilitation setting after major lower-extremity amputation
AU - Huang, Mark E.
AU - Johns, Jeffery S.
AU - White, Joy
AU - Sanford, Kim
N1 - Funding Information:
Supported in part by the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitative Services, US Department of Education (grant no. H133B980009). The contents of this article do not necessarily represent the policy of the US Department of Education, and you should not assume endorsement by the federal government.
PY - 2005/1
Y1 - 2005/1
N2 - Objective To determine the prevalence of venous thromboembolic disease (VTED) and impact on functional outcome in patients with major lower-extremity (LE) amputation admitted to an inpatient rehabilitation unit. Design Retrospective medical records review. Setting Acute inpatient rehabilitation unit in a tertiary, urban academic medical center. Participants Fifty consecutive patients admitted to an acute inpatient rehabilitation unit after a major LE amputation. Participants were screened at rehabilitation admission for LE deep vein thrombosis using duplex ultrasonography. Interventions Not applicable. Main outcome measures VTED incidence, FIM instrument, total rehabilitation charges, and length of stay (LOS). Results Six of 50 patients (12%) had evidence of VTED. The VTED cohort had significantly lower admission and discharge FIM scores than the no-VTED cohort (admission FIM score, 57.2 vs 76.0; discharge FIM score, 66.0 vs 90.1, respectively; P≤.02). Subjects with VTED had a longer rehabilitation LOS (22.8d vs 13.9d, respectively; P=.02) and higher total rehabilitation charges ($28,314 vs $17,724, respectively; P<.05). Conclusions In this study, VTED prevalence after LE amputation in a rehabilitation setting was 12%. Subjects with VTED had lower admission and discharge functional status, longer LOS, and higher hospital charges. The utility of screening duplex ultrasound examinations at rehabilitation admission remains unclear.
AB - Objective To determine the prevalence of venous thromboembolic disease (VTED) and impact on functional outcome in patients with major lower-extremity (LE) amputation admitted to an inpatient rehabilitation unit. Design Retrospective medical records review. Setting Acute inpatient rehabilitation unit in a tertiary, urban academic medical center. Participants Fifty consecutive patients admitted to an acute inpatient rehabilitation unit after a major LE amputation. Participants were screened at rehabilitation admission for LE deep vein thrombosis using duplex ultrasonography. Interventions Not applicable. Main outcome measures VTED incidence, FIM instrument, total rehabilitation charges, and length of stay (LOS). Results Six of 50 patients (12%) had evidence of VTED. The VTED cohort had significantly lower admission and discharge FIM scores than the no-VTED cohort (admission FIM score, 57.2 vs 76.0; discharge FIM score, 66.0 vs 90.1, respectively; P≤.02). Subjects with VTED had a longer rehabilitation LOS (22.8d vs 13.9d, respectively; P=.02) and higher total rehabilitation charges ($28,314 vs $17,724, respectively; P<.05). Conclusions In this study, VTED prevalence after LE amputation in a rehabilitation setting was 12%. Subjects with VTED had lower admission and discharge functional status, longer LOS, and higher hospital charges. The utility of screening duplex ultrasound examinations at rehabilitation admission remains unclear.
KW - Amputation
KW - Rehabilitation
KW - Thromboembolism
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U2 - 10.1016/j.apmr.2003.12.029
DO - 10.1016/j.apmr.2003.12.029
M3 - Article
C2 - 15640993
AN - SCOPUS:11444262068
SN - 0003-9993
VL - 86
SP - 73
EP - 78
JO - Archives of physical medicine and rehabilitation
JF - Archives of physical medicine and rehabilitation
IS - 1
ER -