Lower-limb amputee rehabilitation in Australia: analysis of a national data set 2004-10

Objective. Examine demographics, clinical characteristics and rehabilitation outcomes of lower-limb amputees, using

the Australasian Rehabilitation Outcomes Centre (AROC) database.

Methods. Lower-limb amputee rehabilitation separations between 2004 and 2010 were identified using AROC

impairment codes 5.3–5.7.1 Analysis was conducted by year, impairment code, Australian National Sub-acute and

Non-Acute Patient (AN-SNAP) classification (S2–224, Functional Independence Measure (FIM) motor(Mot) score

72–91; S2–225, FIM (Mot) score 14–71) and states of Australia.

Results. Mean length of stay (LOS) for all lower-limb amputee episodes was 36.1 days (95% confidence interval (CI):

35.4–36.9). Majority of episodes were unilateral below knee (63.6%), males (71.8%) with a mean age of 67.9 years (95% CI:

67.6–68.3). Year-on-year analysis revealed a trend for increasing LOS and decreasing age. Analysis by impairment code

demonstrated no significant difference in rehabilitation outcomes. Analysis by AN-SNAP found that LOS was 16.2 days

longer for S2–225 than for S2–224 (95% CI: 14.7–17.8,P < 0.001), andFIM(Mot) change was 12.0 points higher for S2–225

than for S2–224 (95% CI: 11.5–12.6, P < 0.001). Analysis by states revealed significant variation in LOS, FIM (Mot) change

and FIM (Mot) efficiency which may be associated with variations in organisation of rehabilitation services across states.

Conclusion. Although amputees represented a comparatively small proportion of all rehabilitation episodes in

Australia, their LOS was significant. Unlike many other rehabilitation conditions, there was no evidence of decreasing

LOS over time. AN-SNAP classes were effective in distinguishing rehabilitation outcomes, and could potentially be used

more effectively in planning rehabilitation programs.