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Published byRiley Iredale Modified over 2 years ago

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OUTCOME & COST ANALYSIS OF PHYSIOTHERAPIST MANUFACTURED TEMPORARY PROSTHESES

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Multi-centre data collection AKA & BKA Started June 2005, collection to June 2007 Hypothesis: The use of temporary prostheses will provide a safe, cost-effective, and efficient means of rehabilitating lower limb amputees

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Effectiveness –Time to temporary & definitive –Time to discharge –Complications such as wound breakdown –Who made the temporary – expert/novice –Number of temporaries to definitive –Time to 2 nd definitive socket (if in data collection period) –Occasions of temporary prosthetic failure & patient weight

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Outcome –Time to definitive –Discharge date –Discharge destination –Aids –10m walk time –2 min walk –Level of independence –Stairs ability –Bed mobility (acute setting – time to first mobilise)

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Where Are We? Number of recruits: –Bankstown13 –Prince Henry7 –Nepean17 –Blue Mountains4 –Liverpool27 –Port Kembla18 –Westmead10? (before interim project) –Dropouts8 –Total88

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Reason for dropout: –2 deceased –1 straight to definitive –2 medical reasons –2 AKAs withdrew as too hard –1 t/f out of area, data lost

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Adverse Events –2 cracks in plaster –1 blister where did not adjust socks –1 screw loose & fell down stairs

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Preliminary Outcome Data 22 clients, 24 limbs. Avg age = 66 Sex: –16 male –6 female Level –AKA = 10 –BKA = 10 –Bilat BKA (at same time) = 2

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Preliminary Outcome Data Reason for amputation: –Cancer2 –Diabetes4 –Orthopaedic1 –PVD14 –Trauma1 –Other2 (inotropic complications)

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Preliminary Outcome Data Co-morbidities: –DM10 –Cardiac9 –Respiratory1 –PVD15 –Cognitive0 –CVA3 –Emotional3 –Amp other leg (earlier)1 –Hep C1 –OA knee1 –Hypotension1 –Epilepsy1

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Preliminary Outcome Data Amputation to Temporary: –Range = 28 to 1355 –Avg = 121.9days (65 days without outlier) Reasons for delay: –Healing11- Staff couldnt make3 –Falls3- Medical1 –Emotional1- Ulcer other foot1 –Waiting list2- Init didnt want1

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Preliminary Outcome Data Temporary to definitive: (20 legs) –Range 52 to 202 days –Avg 102 days 2 AKA withdrew before definitive 2 AKA 2 nd socket within 6 months due to weight gain ~10kg each.

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Preliminary Outcome Data Amputation to Definitive: (20) –Range 87 to 262 days –Avg 162 days (5 ½ months)

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Preliminary Outcome Data Discharge data: (19 clients) –Aids: 1 crutch1 2 crutches1 2 sticks3 Nil6 PUF3 Rollator3 W/c2

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Preliminary Outcome Data Discharge independence: (19) –Independent15 –Supervision2 –SB assist1 –Assistance1

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Preliminary Outcome Data 10m walk times (13) –Range 6 to 52 sec –Avg = 18.2 sec –Avg AKA = 25.8 sec –Avg BKA = 14.6 sec

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Preliminary Outcome Data 2 minute walk results (12): –Range 24m to 135m –Avg = 70m –Avg AKA = 46.2m –Avg BKA = 79.6m

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Where to From Here? 7 months to go. Target (100 recruits) looks achievable. Tidy up missing data. Full analysis of data ??Publish Implications of TGA changes

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