174 Functional Outcomes in Older Patients Following Major Limb Amputation
S Jamal, J Luckhurst, K Hussey- Surgery
Abstract
Aim
More than 5,000 major limb amputations (MLA) are performed annually in the United Kingdom. The relationship between medical co-morbidity and frailty is complex and can have an adverse effect on both mortality and functional capacity. This may be particularly important for older patients. We have attempted to define functional outcome by describing place of discharge, functional capacity and limb-fitting.
Method
This was a retrospective review of a prospectively collated data set on MLA performed in a single Scottish Health Board (NHS Greater Glasgow and Clyde). Older patients were defined as those over 80-years at the time of MLA. Primary outcome measures were place of discharge, functional capacity at the time of follow-up and successful limb fitting.
Results
There were 389 consecutive MLAs performed of which 33 were in patients over the age of 80-years. There were 3 (9.4%) inpatient deaths, and the median duration of stay was 57-days. Only 13 (43.3%) patients were discharged home to independent living. The remaining patients were discharged to either supported living or nursing home care. There were 13 (43.3%) patients who were discharged bed bound. Only 7 (21.2%) were successfully limb-fitted. At 12-months 22 (73.3%) of patients were dead.
Conclusions
MLA in older patients is associated with loss of function and therefore loss of independence. Most patients have died within a year of surgery. These data should help modify expectations for patients, families and clinicians and will help with the process of informed consent.