Early Post-operative Mortality After Major Lower Limb Amputation: A Systematic Review of Population and Regional Based Studies

Background:Older adults with amputations secondary to vascular etiologies may additionally present with cognitive impairment. Cognition plays an important role in the adoption of a prosthetic limb, although the degree and type of impact are debated. Previous literature reviews have not been directed at the specific population of older adults who underwent vascular-related lower limb amputation.Objectives:First, to assess extant literature for relationships between cognitive function and prosthesis-related outcomes in older adults who underwent lower limb amputation for vascular-related etiologies. Second, to perform a critical analysis of prosthesis-related outcomes and cognitive assessments performed in the studies.Study design:Systematic literature review.Methods:A systematic review of the literature was performed in databases using keyword combinations. A total of nine articles were selected to be included in this review.Results:Seven of the nine included studies found a relationship between decreased cognitive function and reduced performance on a prosthesis-related outcome. There were eight different prosthesis-related outcome measures, with only one study utilizing a comprehensive outcome measure.Conclusion:Cognitive impairment can negatively impact successful prosthesis use in older adults with lower limb amputation secondary to vascular complications. Future studies should utilize comprehensive outcome measures that represent the multifaceted constructs of cognition and prosthesis use.Clinical relevanceCognitive assessment of older adults who have undergone lower limb amputation secondary to diabetes related complications or vascular disease can be used to inform clinical decision-making. Clinicians should consider selecting prosthesis-related outcome measures that capture the full breadth of prosthesis use when evaluating patients with cognitive impairment.

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Metabolic costs of activities of daily living in persons with a lower limb amputation: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0213256 ◽

2019 ◽

Vol 14 (3) ◽

pp. e0213256 ◽

Cited By ~ 2

Author(s):

Loeke van Schaik ◽

Jan H. B. Geertzen ◽

Pieter U. Dijkstra ◽

Rienk Dekker

Keyword(s):

Systematic Review ◽

Activities Of Daily Living ◽

Lower Limb ◽

Daily Living ◽

Meta Analysis ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Metabolic Costs

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Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: A systematic review of the literature

Prosthetics and Orthotics International ◽

10.1177/0309364617690394 ◽

2017 ◽

Vol 41 (6) ◽

pp. 537-547 ◽

Cited By ~ 27

Author(s):

Fiona Davie-Smith ◽

Elaine Coulter ◽

Brian Kennon ◽

Sally Wyke ◽

Lorna Paul

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Lower Limb ◽

Peripheral Arterial Occlusive Disease ◽

Arterial Occlusive Disease ◽

Occlusive Disease ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Peripheral Arterial

Background: The majority of lower limb amputations are undertaken in people with peripheral arterial occlusive disease, and approximately 50% have diabetes. Quality of life is an important outcome in lower limb amputations; little is known about what influences it, and therefore how to improve it. Objectives: The aim of this systematic review was to identify the factors that influence quality of life after lower limb amputation for peripheral arterial occlusive disease. Methods: MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science and Cochrane databases were searched to identify articles that quantitatively measured quality of life in those with a lower limb amputation for peripheral arterial occlusive disease. Articles were quality assessed by two assessors, evidence tables summarised each article and a narrative synthesis was performed. Study design: Systematic review. Results: Twelve articles were included. Study designs and outcome measures used varied. Quality assessment scores ranged from 36% to 92%. The ability to walk successfully with a prosthesis had the greatest positive impact on quality of life. A trans-femoral amputation was negatively associated with quality of life due to increased difficulty in walking with a prosthesis. Other factors such as older age, being male, longer time since amputation, level of social support and presence of diabetes also negatively affected quality of life. Conclusion: Being able to walk with a prosthesis is of primary importance to improve quality of life for people with lower limb amputation due to peripheral arterial occlusive disease. To further understand and improve the quality of life of this population, there is a need for more prospective longitudinal studies, with a standardised outcome measure. Clinical relevance This is of clinical relevance to those who are involved in the rehabilitation of persons with lower limb amputations. Improved quality of life is associated with successful prosthetic use and focus should be directed toward achieving this.

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Prevalence and Risk Factors of Lower Limb Amputation in Patients with End-Stage Renal Failure on Dialysis: A Systematic Review

International Journal of Nephrology ◽

10.1155/2016/4870749 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Rajit A. Gilhotra ◽

Beverly T. Rodrigues ◽

Venkat N. Vangaveti ◽

Usman H. Malabu

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Renal Failure ◽

Risk Factor ◽

Lower Limb ◽

Renal Dialysis ◽

Lower Limb Amputation ◽

Limb Amputation ◽

End Stage Renal Failure ◽

End Stage

Background.Renal dialysis has recently been recognised as a risk factor for lower limb amputation (LLA). However, exact rates and associated risk factors for the LLA are incompletely understood.Aim.Prevalence and risk factors of LLA in end-stage renal failure (ESRF) subjects on renal dialysis were investigated from the existing literature.Methods.Published data on the subject were derived from MEDLINE, PubMed, and Google Scholar search of English language literature from January 1, 1980, to July 31, 2015, using designated key words.Results.Seventy studies were identified out of which 6 full-text published studies were included in this systematic review of which 5 included patients on haemodialysis alone and one included patients on both haemodialysis and peritoneal dialysis. The reported findings on prevalence of amputation in the renal failure on dialysis cohort ranged from 1.7% to 13.4%. Five out of the six studies identified diabetes as the leading risk factor for amputation in subjects with ESRF on renal dialysis. Other risk factors identified were high haemoglobin A1c, elevated c-reactive protein, and low serum albumin.Conclusions.This review demonstrates high rate of LLA in ESRF patients receiving dialysis therapy. It has also identified diabetes and markers of inflammation as risk factors of amputation in ESRF subjects on dialysis.

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