The effectiveness of inpatient rehabilitation in the acute postoperative phase of care after transtibial or transfemoral amputation: study of an integrated health care delivery system.

Journal Article (Journal Article;Multicenter Study)

OBJECTIVE: To compare outcomes between lower-extremity amputees who receive and do not receive acute postoperative inpatient rehabilitation within a large integrated health care delivery system. DESIGN: An observational study using multivariable propensity score risk adjustment to reduce treatment selection bias. SETTING: Data compiled from 9 administrative databases from Veterans Affairs Medical Centers. PARTICIPANTS: A national cohort of veterans (N=2673) who underwent transtibial or transfemoral amputation between October 1, 2002, and September 30, 2004. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: One-year cumulative survival, home discharge from the hospital, and prosthetic limb procurement within the first postoperative year. RESULTS: After reducing selection bias, patients who received acute postoperative inpatient rehabilitation compared to those with no evidence of inpatient rehabilitation had an increased likelihood of 1-year survival (odds ratio [OR]=1.51; 95% confidence interval [CI], 1.26-1.80) and home discharge (OR=2.58; 95% CI, 2.17-3.06). Prosthetic limb procurement did not differ significantly between groups. CONCLUSIONS: The receipt of rehabilitation in the acute postoperative inpatient period was associated with a greater likelihood of 1-year survival and home discharge from the hospital. Results support early postoperative inpatient rehabilitation following amputation.

Full Text

Duke Authors

Cited Authors

  • Stineman, MG; Kwong, PL; Kurichi, JE; Prvu-Bettger, JA; Vogel, WB; Maislin, G; Bates, BE; Reker, DM

Published Date

  • October 2008

Published In

Volume / Issue

  • 89 / 10

Start / End Page

  • 1863 - 1872

PubMed ID

  • 18929014

Pubmed Central ID

  • PMC2880880

Electronic International Standard Serial Number (EISSN)

  • 1532-821X

Digital Object Identifier (DOI)

  • 10.1016/j.apmr.2008.03.013


  • eng

Conference Location

  • United States