scholarly journals Re-amputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Shinsuke Imaoka ◽  
Koji Sato ◽  
Masahide Furukawa ◽  
Minoru Okita ◽  
Toshio Higashi
Keyword(s):  
Risk Factors ◽  
Physical Therapy ◽  
Lower Limb ◽  
Care Center ◽  
Functional Independence ◽  
Cox Proportional Hazards ◽  
Ankle Dorsiflexion ◽  
Amputation Rate ◽  
Modifiable Risk Factors ◽  
Post Discharge

Abstract Background Diabetes-related foot lesions are a major cause of non-traumatic lower limb amputations and are associated with a high re-amputation rate. Lesions can cause hindrance in activities of daily living, reduce physical function, and lower a patient’s quality of life. Physical therapy is necessary to prevent these limitations. Thus far, there has been limited investigation into the re-amputation rate in patients who have undergone physical therapy. This study aimed to elucidate modifiable risk factors for re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization. Methods This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records to surgical and physical therapy units stored in the electronic medical records. We examined re-amputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was set at 1 year. We used Cox proportional hazards analysis to examine factors affecting the risk of re-amputation. Results Of the 129 patients enrolled, 42 patients (32.5%) underwent re-amputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with re-amputation were a requirement for hemodialysis, ankle dorsiflexion angle, and the Functional Independence Measure (FIM) ambulation score. Conclusions In diabetes patients with minor amputations, a requirement for hemodialysis, ankle dorsiflexion angle, and the FIM ambulation score were shown to be modifiable risk factors for re-amputation. This emphasizes that maintaining vascular endothelial function through lower limb muscle exercises for hemodialysis, improving ankle mobility, and relieving plantar pressure during walking are necessary to reduce the risk of re-amputation. Patients with these risk factors should be encouraged to participate in physical therapy.

scholarly journals Re-amputation in patients with diabetes -related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

2021 ◽  
Author(s):  
Shinsuke Imaoka ◽  
Koji Sato ◽  
Masahide Furukawa ◽  
Minoru Okita ◽  
Toshio Higashi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Physical Therapy ◽  
Retrospective Cohort Study ◽  
Lower Limb ◽  
Retrospective Cohort ◽  
Functional Independence ◽  
Ankle Dorsiflexion ◽  
Amputation Rate ◽  
Modifiable Risk Factors

Abstract Background：Diabetes-related foot lesions are a major cause of non-traumatic lower limb amputations and are associated with a high re-amputation rate. Lesions can cause hindrance in activities of daily living, reduce physical function, and lower a patient’s quality of life. Physical therapy is necessary to prevent these limitations. Thus far, there has been limited investigation into the re-amputation rate in patients who have undergone physical therapy. This study aimed to elucidate modifiable risk factors for re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods：This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records to surgical and physical therapy units stored in the electronic medical records. We examined re-amputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was set at 1 year. We used Cox proportional hazards analysis to examine factors affecting the risk of re-amputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent re-amputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with re-amputation were a requirement for hemodialysis, ankle dorsiflexion angle, and the Functional Independence Measure (FIM) ambulation score.Conclusions: In diabetes patients with minor amputations, a requirement for hemodialysis, ankle dorsiflexion angle, and the FIM ambulation score were shown to be modifiable risk factors for re-amputation. This emphasizes that maintaining vascular endothelial function through lower limb muscle exercises for hemodialysis, improving ankle mobility, and relieving plantar pressure during walking are necessary to reduce the risk of re-amputation. Patients with these risk factors should be encouraged to participate in physical therapy.

scholarly journals Reamputation in patients with diabetes-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

2020 ◽  
Author(s):  
Shinsuke Imaoka ◽  
Koji Sato ◽  
Masahide Furukawa ◽  
Minoru Okita ◽  
Toshio Higashi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Physical Therapy ◽  
Retrospective Cohort Study ◽  
Lower Limb ◽  
Retrospective Cohort ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Amputation Rate ◽  
Modifiable Risk Factors

Abstract Background：Diabetes-related foot lesions are a major cause of non-traumatic lower limb amputations and are associated with a high re-amputation rate. Lesions can cause hindrance in activities of daily living, reduce physical function, and lower a patient’s quality of life. Physical therapy is necessary to prevent these limitations. Thus far, there has been limited investigation into the re-amputation rate in patients who have undergone physical therapy. This study aimed to elucidate modifiable risk factors for re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods：This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records (to surgical and physical therapy units) stored in the electronic medical records. We examined reamputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was set at 1 year. We used Cox proportional hazards analysis to examine factors affecting the risk of reamputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent reamputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with reamputation were a requirement for hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: In diabetes patients with minor amputations, requirement for hemodialysis, ankle dorsiflexion angle, and functional independence measure (FIM) ambulation were shown to be modifiable risk factors for re-amputation. This emphasizes that maintaining vascular endothelial function through lower limb muscle exercises for hemodialysis, improving ankle mobility, and off-loading walking are necessary to reduce the risk of reamputation. Patients with these risk factors should be encouraged to participate in physical therapy.

scholarly journals Reamputation in patients with diabetic-related minor amputations who underwent physical therapy during their hospitalization. A single-facility retrospective cohort study

2020 ◽  
Author(s):  
Shinsuke Imaoka ◽  
Koji Sato ◽  
Masahide Furukawa ◽  
Minoru Okita ◽  
Toshio Higashi
Keyword(s):  
Cohort Study ◽  
Physical Therapy ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Care Center ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Ankle Dorsiflexion ◽  
Factors Associated ◽  
Minor Amputation

Abstract Background: Diabetic foot lesions are a major cause of non-traumatic lower limb amputations; they can interfere with daily life, reduce physical function and lower a patient’s quality of life. Physical therapy is necessary to prevent such social disadvantage. Patients at high risk of reamputation may require physical therapy to prevent reamputation. The purpose of this study was to elucidate the factors that influence re-amputation in patients with minor amputations who were treated with physical therapy during their hospitalization.Methods: This was a retrospective cohort study of 245 consecutive hospitalized patients who presented to our Wound Care Center between January 2015 and February 2018 and received physical therapy after a minor amputation. Participants were identified from admission records (to surgical and physical therapy units) stored in the electronic medical records. We examined reamputations that occurred in the ipsilateral lower extremity during the 1-year post-discharge outpatient period. The maximum follow-up period was１year. We used Cox proportional hazards analysis to examine factors affecting the risk of reamputation.Results: Of the 129 patients enrolled, 42 patients (32.5%) underwent reamputations during an average observation period of 6.2 months (range, 2.1 to 10.9 months). The factors associated with reamputation were a requirement for hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: We identified a requirement for hemodialysis, ankle dorsiflexion angle, and functional independence measure (FIM) ambulation as the factors associated with reamputation in patients with diabetes who had undergone minor amputation. In the future, developing a physical therapy program that focuses on these factors could help reduce reamputations.

scholarly journals A population-based assessment of the post-operative complications rates and 30-day mortality associated with lower limb amputations at a tertiary care center in Riyadh, Saudi Arabia

2021 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
Nader S. Alkenani ◽  
Sarah M. Alghaihab ◽  
Shouq M. Alnujaim ◽  
Sadeem A. Aldakhil ◽  
Sara H. Alsinan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Saudi Arabia ◽  
Lower Limb ◽  
Care Center ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Phantom Limb ◽  
Complication Rates ◽  
Cross Sectional ◽  
Stump Pain

Objectives: There is no consensus on the postoperative 30-day mortality, complication rates, and their risk factors post lower limb amputations (LLA) in the literature, especially in Saudi Arabia. To address this gap, we assessed these three parameters in our patients who underwent LLAs. Methods: We conducted a retrospective cross-sectional study in King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 2015 and 2019. Using non-probability purposive sampling, we targeted 318 adults who underwent LLA at our hospital. The primary outcome variables were postoperative 30-day mortality and complications, such as stump pain, wound infections, hemorrhage, and acute kidney injury. In addition, we collected data on demographics, comorbidities, and clinical course from electronic medical records. Results: We assessed 318 patients (mean age = 65.7 [SD = 0.840] years), most of whom were male patients (68.6%) with endocrine and metabolic disorders (92.1%). Most amputees (87.1%) had peripheral vascular diseases as the main indication for LLA at an above-knee level (62.6%). The 30-day mortality and complication rates were 6.6% and 74%, respectively. Intermediate complications predominated (57%), with stump pain (17.3%) and phantom limb pain (15.4%) being the most common. Thirty-day mortality was significantly associated with some patient characteristics and comorbid kidneys and neurological disorders. The immediate, intermediate, and late complications were significantly related to smoking and several renal, vascular, and respiratory disorders. Conclusion: Calculating the 30-day mortality and complication rates after LLA and mapping the associated risk factors helped identify high-risk patients, deliver better treatment, lower medical costs, and establish protective measures.

scholarly journals Factors Related to Reamputation in Patients with Diabetes Who Have Undergone Minor Amputation: A Single-Facility Retrospective Cohort Study

2020 ◽  
Author(s):  
Shinsuke Imaoka ◽  
Koji Sato ◽  
Masahide Furukawa ◽  
Minoru Okita ◽  
Toshio Higashi
Keyword(s):  
Proportional Hazards ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Rehabilitation Program ◽  
Cox Proportional Hazards ◽  
Ankle Dorsiflexion ◽  
Factors Associated ◽  
Minor Amputation ◽  
Number Of Patients ◽  
Patients With Diabetes

Abstract Background: With aging, there has been an increase in the number of patients with lower limb amputations, especially in Japan. Previous studies have reported that minor amputation after limb salvage is associated with a high recurrence, with the ulcer recurring within 10.5 months. Age, wounded area, history of peripheral artery disease, and wound infection have been reported as the risk factors of recurrence. Thus far, there are no studies on the association between rehabilitation and reamputation. This study therefore aimed to examine factors predictive of reamputation in patients with diabetes who have undergone minor amputation for developing a rehabilitation program.Methods: This study included 129 patients who had undergone physical therapy between January 2015 and February 2018. The patients were assigned to the reamputation and non-reamputation groups. We retrospectively studied the patients’ medical records and compared the factors between the groups. Next, we analyzed the differences between the factors using Cox proportional hazards analysis.Results: During the follow-up period, 42 patients (35.2%) underwent reamputation. The factors associated with reamputation were hemodialysis, ankle dorsiflexion angle, and ambulation Functional Independence Measure score.Conclusions: We identified hemodialysis, ankle dorsiflexion angle, and FIM ambulation were the factors associated with reamputation in patients with diabetes who had undergone minor amputation． Future developing a rehabilitation program focusing on these factors could reduce reamputations.

Predicting attrition in long-term residential substance use disorder treatment: A modifiable risk factors perspective.

2020 ◽  
Vol 17 (4) ◽  
pp. 472-482
Author(s):  
Danielle E. Baker ◽  
Keith A. Edmonds ◽  
Maegan L. Calvert ◽  
Sarah M. Sanders ◽  
Ana J. Bridges ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Modifiable Risk Factors ◽  
Substance Use Disorder Treatment ◽  
Disorder Treatment

Controlling Hypertension and Stroke Prevention – From Guideline to Clinical Practice

2011 ◽  
Vol 3 (1) ◽  
pp. 30
Author(s):  
Anding Xu ◽  
Zefeng Tan ◽  
◽  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Clinical Trials ◽  
Clinical Practice ◽  
Stroke Prevention ◽  
Modifiable Risk Factors ◽  
Cerebrovascular Events

Hypertension is the most important of the prevalent and modifiable risk factors for stroke. Based on evidence, blood pressure (BP) lowering is recommended in guidelines for the prevention of stroke. However, there are still some uncertainties in the guidelines for controlling BP and preventing stroke in patients with previous cerebrovascular events, such as the goal BP, who to treat and which class of BP-lowering drugs to use. This article discusses these questions by reviewing guidelines and corresponding clinical trials, with the aim of reducing the gap between guidelines and clinical practice.

Study of risk factors of eclampsia in a tertiary care center

2019 ◽  
Vol 12 (2) ◽  
pp. 31-35
Author(s):  
Padma Chandavathu ◽  
◽  
Akurathi Krishna Rao ◽  
Keyword(s):  
Risk Factors ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center
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