Functioning and health in a population of lower limb amputees in Medellín, Colombia
DOI:
https://doi.org/10.17533/udea.iatreia.325189Keywords:
amputees, EQ-5D, functioning, quality of life, WHO-DAS IIAbstract
General objective: To describe a measure of the functioning and perceived health status among lower limb amputees in Medellín, Colombia.
Methodology: Cross-sectional study to assess functioning with the WHO-DAS and health status with the EQ-5D in patients with lower limb amputation.
Results: 154 patients were interviewed. The mobility domain of the WHO-DAS was the most affected in amputees over the knee (average: 21.66; DE: 17.61) and under the knee (average: 25.77; DE: 22.89). There were significant differences only according to the time since the amputation. In the EQ-5D, the average utility weight value was 0.821 among those with 5 years or less since amputation, and 0.920 (p = 0.022) in those amputated more than 10 years before. Results of health perception on the visual analog scale showed similar and statistically significant differences.
Conclusion: In the analyzed sample, functioning and quality of life are more associated with time since amputation than with the level or etiology of this intervention.
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(1.) Huang ME, Ann Miller L, Lipschutz R, Todd A. Rehabilitation and prosthetic restoration in lower limb amputation. In: Braddom RL. Physical Medicine and Rehabilitation. 4a ed. Philadelphia: Elsevier Saunders; 2011. p. 277.
(2.) Walsh NE, Gordon Bosker G, Santa María D. Upper and Lower Extremity Prosthetics. In: DeLisa JA. Physical Medicine and Rehabilitation. Principles and practice. 5a ed. Philadelphia: Lippincott Williams and Wilkins; 2010. p. 2017-19.
(3.) Godlwana L, Nadasan T, Puckree T. Global trends in incidence of lower limb amputation: a review of the literature. S Afr J Physiother. 2008; 64(1):8-12. DOI 10.4102/sajp.v64i1.93.
(4.) Johannesson A, Larsson GU, Ramstrand N, Turkiewicz A, Wiréhn AB, Atroshi I. Incidence of lower-limb amputation in the diabetic and nondiabetic general population: a 10-year population-based cohort study of initial unilateral and contralateral amputations and reamputations. Diabetes Care. 2009 Feb;32(2):275-80. DOI 10.2337/dc08-1639.
(5.) Descontamina Colombia [Internet]. Bogotá: Dirección Contra Minas; 2016 [consultado 2016 Ene 22]. Dirección para la Acción Integral contra Minas Antipersonales. Disponible en: http://www.accioncontraminas.gov.co/direccion/Paginas/Director.aspx
(6.) Colombia. Ministerio de Salud y Protección Social. Guía de práctica clínica para el diagnóstico y tratamiento preoperatorio, intraoperatorio y postoperatorio de la persona amputada, la prescripción de la prótesis y la rehabilitación integral. Guía para profesionales de la salud [GPC en Internet]. Edición 1°. Bogotá D.C: El Ministerio; 2016 [consultado 2016]. Disponible en: http://gpc.minsalud.gov.co/gpc_sites/Repositorio/Conv_637/GPC_amputacion/gpc_amputacion_completa.aspx
(7.) Sexton S, Jované R, Rosario D, Castañeda M. Prosthetics & Orthotics Impact Assessment Latin America: México, Guatemala and Colombia [Internet]. Brussels: International Society for Prosthetics and Orthotics; 2015[cited 2015 Sep 28]. Available from: http://www.ispoint.org/sites/default/files/mexico_guatemala_colombia_ispo_impact_assessment_report_low_resolution.pdf
(8.) World Health Organization [Internet]. Geneva: WHO; 2015. [cited 2015 Jan 16].Health statistics and information systems. Global Health Estimates (GHE) Available from: http://www.who.int/healthinfo/global_burden_disease/en/
(9.) Larsson J, Apelqvist J. Towards less amputations in diabetic patients: Incidence, causes, cost, treatment, and prevention—a review. Acta Orthop Scand. 1995;66(2):181-92. DOI 10.3109/17453679508995520.
(10.) Kannel WB, Skinner JJ Jr, Schwartz MJ, Shurtleff D. Intermittent claudication. Incidence in the Framingham Study. Circulation. 1970 May;41(5):875-83.
(11.) Creager Joseph Loscalzo MA. Enfermedades arteriales de las extremidades. En: Kasper D, editor. Harrison Principios de Medicina Interna. 19ª ed. Madrid: McGraw-Hill; 2016. p. 1643-49. DOI 10.1177/0309364611418019.
(12.) Burger H. Can the International Classification of Functioning, Disability and Health (ICF) be used in a prosthetics and orthotics outpatient clinic? Prosthet Orthot Int. 2011 Sep;35(3):302-9. DOI 10.1177/0309364611418019.
(13.) World Health Organization. Measuring health and disability: Manual for WHO Disability Assessment Schedule. WHODAS 2.0. Üstün TB, Kostanjsek N, Chatterji S, Rehm J, editors [Internet]. Geneva: World Health Organization; 2010 [cited 2016 Jan 10]. Available from: http://apps.who.int/iris/bitstream/10665/43974/1/9789241547598_eng.pdf
(14.) Alva M, Gray A, Mihaylova B, Clarke P. The effect of diabetes complications on health-related quality of life: the importance of longitudinal data to address patient heterogeneity. Health Econ. 2014 Apr;23(4):487-500. DOI 10.1002/hec.2930.
(15.) Ministerio de Sanidad, Servicios Sociales e Igualdad. Encuesta Nacional de Salud. España 2011/12. Serie Informes monográficos nº 3. Calidad de vida relacionada con la salud en adultos: EQ-5D-5L [Internet]. Madrid: Ministerio de Sanidad; 2014 [consultado 2015 Ene 16]. Disponible en: http://www.msssi.gob.es/estadEstudios/estadisticas/encuestaNacional/encuestaNac2011/informesMonograficos/CVRS_adultos_EQ_5D_5L.pdf
(16.) EuroQol Research Foundation. What is EQ-5D [Internet]. Rotterdam: EuroQol Research Foundation; 2016 [cited 2016 Jan 10]. Available from: http://www.euroqol.org/home.html
(17.) Brooks R. EuroQol: the current state of play. Health Policy. 1996 Jul;37(1):53-72.
(18.) van Reenen M, Oppe M. EQ-5D-3L User Guide Basic information on how to use the EQ-5D-3L instrument. Version 5.1 [Internet]. [cited 2015 Jan 16]. Available from: http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_Flyers/EQ-5D-3L_UserGuide_2015.pdf
(19.) Bailey H, Kind P. Preliminary findings of an investigation into the relationship between national culture and EQ-5D value sets. Qual Life Res. 2010 Oct;19(8):1145-54. DOI 10.1007/s11136-010-9678-5.
(20.) Norman R, Cronin P, Viney R, King M, Street D, Ratcliffe J. International comparisons in valuing EQ-5D health states: a review and analysis. Value Health. 2009 Nov-Dec;12(8):1194-200. DOI 10.1111/j.1524-4733.2009.00581.x.
(21.) Zarate V, Kind P, Chuang LH. Hispanic valuation of the EQ-5D health states: a social value set for Latin Americans. Value Health. 2008 Dec;11(7):1170-7. DOI 10.1111/j.1524-4733.2008.00349.x.
(22.) Selai C. EQ-5D: Modes of administration. In: Brooks R, Rabin R, de Charro F, editors. The Measurement and Valuation of Health Status Using EQ-5D: A European Perspective. Evidence from the EuroQol BIOMED Research Programme. Netherlands: Springer; 2003. p. 21-8.
(23.) Organización Mundial de la Salud. Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud [Internet]. Ginebra: OMG; 2001. [consultado 2015 Ene 16]. Disponible en: http://apps.who.int/iris/bitstream/10665/43360/1/9241545445_spa.pdf
(24.) García Obrero I, Echevarría Ruiz de Vargas C, Sánchez Navarro C, García Díaz J, Polo Piñeiro JM, Rodríguez-Piñero Bravo-Ferrer M. Escalas de valoración funcional en el paciente amputado. Rehabilitación. 1998 Feb;32(2):113-25.
(25.) Gallagher P, O’Donovan MA, Doyle A, Desmond D. Environmental barriers, activity limitations and participation restrictions experienced by people with major limb amputation. Prosthet Orthot Int. 2011 Sep;35(3):278-84. DOI 10.1177/0309364611407108.
(26.) Coffey L, Gallagher P, Desmond D. Goal pursuit and goal adjustment as predictors of disability and quality of life among individuals with a lower limb amputation: a prospective study. Arch Phys Med Rehabil. 2014 Feb;95(2):244-52. DOI 10.1016/j.apmr.2013.08.011.
(27.) EuroQol Group. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990 Dec;16(3):199-208.
(28.) Ragnarson Tennvall G, Apelqvist J. Health-related quality of life in patients with diabetes mellitus and foot ulcers. J Diabetes Complications. 2000 Sep-Oct;14(5):235-41.
(29.) Gerzeli S, Torbica A, Fattore G. Cost utility analysis of knee prosthesis with complete microprocessor control (C-leg) compared with mechanical technology in trans-femoral amputees. Eur J Health Econ. 2009 Feb;10(1):47-55. DOI 10.1007/s10198-008-0102-9.
(30.) Cutti AG, Lettieri E, Del Maestro M, Radaelli G, Luchetti M, Verni G, et al. Stratified cost-utility analysis of C-Leg versus mechanical knees: Findings from an Italian sample of transfemoral amputees. Prosthet Orthot Int. 2016 Mar. pii: 0309364616637955.
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