What happens to the diabetic amputee after leaving hospital? - abstract

ABSTRACT

Very little known of the background, long-term functioning and survival of the amputee, especially in a West Indian setting. A questionnaire was designed to assess the social, domestic and economic effects of amputation in the diabetic. Statistics from the Department of Surgery, General Hospital, Port-of-Spain revealed that 126 patients with above- or below-knee (AK/BK) amputations were discharged from hospital from 1985 to 1988. Eighteen patients were not diabetic and were excluded and 11 could not be located. Data on the remaining 97 amputees were obtained by interviews with patients or relatives of those who had died. Most (76 percent) patients were >60 years old, and the majority were Negroes (66 percent). Sixty-six patients had AK while 31 had BK amputations. At the time of the survey, 36 (37 percent) patients had died, more than two-thirds (69 percent) of deaths occurring within 6 months after discharge. Only 5 percent used prosthesis, and 20 percent remained permanently bed-ridden. Over 90 percent of those employed experienced a fall in income. Only 6 percent were visited by a social worker. About one-quarter (24 percent) felt quite despondent since amputation. Lower limb amputation results in great psychological, social and economic disability and is associated with a high mortality. Much effort is required to prevent limb loss in the diabetic. Aggressive rehabilitation with early prosthetic fitting should improve the outcome for amputees (AU)