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.
Arch Phys Med Rehabil
; 89(10): 1863-72, 2008 Oct.
Article
em En
| MEDLINE
| ID: mdl-18929014
ABSTRACT
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 OUTCOMEMEASURES:
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Prestação Integrada de Cuidados de Saúde
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Amputação Cirúrgica
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Amputados
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Perna (Membro)
Tipo de estudo:
Clinical_trials
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Evaluation_studies
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Observational_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article