REHABILITATION OUTCOMES IN PATIENTS WITH LOWER LIMB AMPUTATION RECEIVING HAEMODIALYSIS: A RETROSPECTIVE COHORT STUDY.

Yoshitaka Wada, Yohei Otaka, Yuki Senju, Hiroshi Hosokawa, Takamichi Tohyama, Hirofumi Maeda, Masahiko Mukaino, Seiko Shibata, Satoshi Hirano
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Abstract

Objective: To compare the functional outcomes of patients with lower limb amputations receiving haemodialysis and those not receiving haemodialysis.

Design: A retrospective cohort study.

Patients: Patients with lower limb amputation who were admitted to a convalescent rehabilitation ward between January 2018 and December 2021.

Methods: The primary outcome was the effectiveness of the Functional Independence Measure (FIM) during hospitalisation in the ward. Secondary outcomes included the total and subtotal (motor/cognitive) FIM scores at discharge, gain in the total and subtotal (motor/cognitive) FIM scores, K-level at discharge, length of hospital stay in the ward, rehabilitation time, and discharge destination. Outcomes were compared between the non-haemodialysis and haemodialysis groups.

Results: A total of 28 patients (mean [standard deviation] age, 67.0 [11.9] years; men, 20) were enrolled in this study. Among them, 11 patients underwent haemodialysis. The FIM effectiveness was significantly higher in the non-haemodialysis group than in the haemodialysis group (median [interquartile range], 0.78 [0.72 - 0.81] vs 0.65 [0.28 - 0.75], p = 0.038). The amount of rehabilitation and all secondary outcomes were not significantly different between the groups (p > 0.05).

Conclusion: Patients with lower limb amputation who were receiving haemodialysis had poorer FIM effectiveness than those not receiving haemodialysis.

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下肢截肢患者接受血液透析的康复效果:一项回顾性队列研究。
目的:比较下肢截肢患者接受血液透析与不接受血液透析的功能结局。设计:回顾性队列研究。患者:2018年1月至2021年12月入住康复病房的下肢截肢患者。方法:主要观察指标是病房住院期间功能独立性测量(FIM)的有效性。次要结局包括出院时FIM总分和小计分数(运动/认知)、FIM总分和小计分数(运动/认知)的增加、出院时的k水平、住院时间、康复时间和出院目的地。比较非血液透析组和血液透析组的结果。结果:共28例患者(平均[标准差]年龄67.0[11.9]岁;共有20名男性参加了这项研究。其中11例患者行血液透析。非血液透析组的FIM有效性显著高于血液透析组(中位数[四分位数范围],0.78 [0.72 - 0.81]vs 0.65 [0.28 - 0.75], p = 0.038)。两组间康复量及各项次要结局比较,差异均无统计学意义(p > 0.05)。结论:下肢截肢患者接受血液透析的FIM效果较不接受血液透析的患者差。
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