JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Vol. Xl, n 1, June 2024
Pages: 1312-1320
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Assessment of Quality of Life Among Moroccan Patients with Major Lower Limb Amputation: A Cross-Sectional Study
Author: Mohammed Elaatmani, Aziz Ahizoune, Hicham Essaffani, Mustapha Bouaoudate, Mohamed Kharmaz, Redouane Abouqal, Rachid Razine, Khalid Abidi
Category: JMSR Patient Care
Abstract:
Background & objectives: Despite advances in awareness and prevention the major amputation of the lower limb. MLLA is expanding and contributing to a significant disease burden in both developed and developing countries. The aim of this research was to explore the influence of major lower limb amputation (MLLA) on the quality of life (QOL) of Moroccan patients in the immediate postoperative period and three months after discharge. Materials and methods: Prospective observational study assessing the QOL of patients with MLLA during the 48 hours following the amputation procedure and three months after discharge, using the Arabic version of SF-12 quality of life questionnaire. Results: The study included 101 patients in the first assessment during the 48 hours following the amputation (T0), and 86 patients were included in the second assessment three months after discharge (T1). The mean age of patients with MLLA was 59.3 ± 16 years with a male predominance (70.3%). The main cause of MLLA was diabetic foot (47.5%). The mean global score of the SF-12 at T0 and T1 were 31.93±6.91 and 39.58±5.19 respectively. The physical component summary (PCS) was significantly lower than the mental component summary (MCS) at T0 and at T1, but a significant increase (p<0.001) of PCS and MCS was seen in patients with MLLA at T1. In multivariate regression the independents factors associated with lower PCS were limitation of mobility, age, general anaesthesia, length of hospital stay, reamputation and stump pain. While total mobility assistance, partial mobility assistance, length of hospital stay, peripheral nerve block and heart disease had a negative impact on the MCS of patients with MLLA.Conclusion: Patients with a MLLA had a poor QOL in terms of both physical and mental health. Limitation of mobility, advanced age, type of anaesthesia, stump pain, reamputation and heart disease appear to be risk factors for poor QOL. Young age, male gender, absence of comorbidity, information and explanation of the amputation procedure to the patient, absence of stump pain, early mobility and fitting are factors related to good QOL.
Keywords: Quality of life, SF-12, physical health, mental health, major amputation, lower limb
References:
1. Oliveira YS, Mba Angoue JM, Nguimbi Mbadinga AM, Feimokib D, Magossou P, Ibinga AF, et al. Amputation des membres inférieurs et appareillage?: expérience du centre de réadaptation et d’appareillage pour handicaps «?La Raison de Vivre, Le Droit d’Espérer?» à Libreville. Journal de Réadaptation Médicale?: Pratique et Formation en Médecine Physique et de Réadaptation. 2014;34:53?9.
2. de Godoy JMP, Braile DM, Buzatto SHG, Longo O, Fontes OA. Quality of life after amputation. Psychology, Health & Medicine. 2002;7:397?400.
3. Em S, Karakoc M, Sariyildiz MA, Bozkurt M, Aydin A, Cevik R, et al. Assessment of sexual function and quality of life in patients with lower limb amputations. Journal of Back & Musculoskeletal Rehabilitation. 2019;32:277?85.
4. K Z-G, Ej M, Pl E, Tg T, R B. Estimating the prevalence of limb loss in the United States: 2005 to 2050. Archives of physical medicine and rehabilitation [Internet]. 2008 [cité 27 avr 2022];89. Disponible sur: https://pubmed.ncbi.nlm.nih.gov/18295618/
5. Davie-Smith F, Coulter E, Kennon B, Wyke S, Paul L. Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: A systematic review of the literature. Prosthet Orthot Int. 2017;41:537?47.
6. Oliveira Y-S, Iba Ba J, Nsame D, Mba Angoue J-M, Lebane A, Minooee Saberi K, et al. Les causes d’amputations des membres inférieurs en rééducation?: impact de l’insuffisance artérielle et du diabète. Journal de Réadaptation Médicale?: Pratique et Formation en Médecine Physique et de Réadaptation. 2013;33:122?6.
7. Vanmarsenille J-M, Dierick F, Detrembleur C, De Cuyper F. L’appareillage de l’amputé de jambe adulte. Louvain médical. 2001;120:349?53.
8. WHOQOL - Measuring Quality of Life| The World Health Organization [Internet]. [cité 11 févr 2022]. Disponible sur: https://www.who.int/tools/whoqol
9. Abdelgadir M, Shebeika W, Eltom M, Berne C, Wikblad K. Health related quality of life and sense of coherence in Sudanese diabetic subjects with lower limb amputation. The Tohoku journal of experimental medicine. 2009;217:45?50.
10. Hisam A, Ashraf F, Rana MN, Waqar Y, Karim S, Irfan F. Health related quality of life in patients with single lower limb amputation. Journal of the College of Physicians and Surgeons—Pakistan: JCPSP. 2016;26:851?4.
11. Zaheer A, Sharif F, Khan Z, Batool S, Iqbal H. Quality of Life and Depression among Lower Limb Amputees. Annals of King Edward Medical University. 2020;26:364?8.
12. Faraji E, Allami M, Feizollahi N, Karimi A, Yavari A, Soroush M, et al. Health concerns of veterans with high-level lower extremity amputations. Military Medical Research. 2018;5:36.
13. van der Merwe L, Birkholtz F, Tetsworth K, Hohmann E. Functional and psychological outcomes of delayed lower limb amputation following failed lower limb reconstruction. Injury. 2016;47:1756?60.
14. Hawkins AT, Henry AJ, Crandell DM, Nguyen LL. A Systematic Review of Functional and Quality of Life Assessment after Major Lower Extremity Amputation. Annals of Vascular Surgery. 2014;28:763?80.
15. Kneževi? A, Salamon T, Milankov M, Ninkovi? S, Jeremi? Kneževi? M, Tomaševi? Todorovi? S. ASSESSMENT OF QUALITY OF LIFE IN PATIENTS AFTER LOWER LIMB AMPUTATION. Med Pregl. 2015;68:103?8.
16. Sinha R, van den Heuvel WJA, Arokiasamy P, van Dijk JP. Influence of adjustments to amputation and artificial limb on quality of life in patients following lower limb amputation. International Journal of Rehabilitation Research. 2014;37:74?9.
17. Alberto E, Michael K. Lower Limb Amputations: Epidemiology and Assessment [Internet]. PM&R KnowledgeNow. 2017 [cité 27 avr 2022]. Disponible sur: https://now.aapmr.org/lower-limb-amputations-epidemiology-and-assessment/
18. Nelson MT, Greenblatt DY, Soma G, Rajimanickam V, Greenberg CC, Kent KC. Preoperative factors predict mortality after major lower-extremity amputation. Surgery. 2012;152:685?94; discussion 694-696.
19. Obtel M, Rhazi KE, Nejjari C, Elhold S, Benjelloune MC, Gnatiuc L. Cross-cultural adaptation of the 12-Item Short-Form survey instrument in a Moroccan representative survey?: original research. Southern African Journal of Epidemiology and Infection. 2013;28:166?71.
20. Ware JE, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: Construction of Scales and Preliminary Tests of Reliability and Validity. Medical Care. 1996;34:220?33.
21. Ware JE, Gandek B. Overview of the SF-36 Health Survey and the International Quality of Life Assessment (IQOLA) Project. Journal of Clinical Epidemiology. 1998;51:903?12.
22. Atiç R, Ayd?n A. Comparison of the demographic and clinical characteristics, functional status and quality of life of lower extremity amputees to identify the reason for undergoing amputation. Journal of back and musculoskeletal rehabilitation. 2018;31:973?9.
23. Barnett CT, Vanicek N, Polman RCJ. Temporal adaptations in generic and population-specific quality of life and falls efficacy in men with recent lower-limb amputations. Journal of Rehabilitation Research & Development. 2013;50:437?47.
24. Mac Neill HL, Devlin M, Pauley T, Yudin A. Long-Term Outcomes and Survival of Patients with Bilateral Transtibial Amputations After Rehabilitation. American Journal of Physical Medicine & Rehabilitation. 2008;87:189?96.
25. Lam T-WJ, Tang L-CL, Chau WW, Law SW, Chan KM. The Effect of Age, Gender and Socioeconomic Status on Self-esteem, Body Image and Quality of Life of Amputees: An Evaluation Seven Years after the 2008 Sichuan Earthquake. Disability, CBR & Inclusive Development. 2019;29:32?47.
26. Ambler GK, Thomas-Jones E, Edwards AGK, Twine CP. Prognostic Risk Modelling for Patients Undergoing Major Lower Limb Amputation: An Analysis of the UK National Vascular Registry. European Journal of Vascular and Endovascular Surgery. 2020;59:606?13.
27. Amtmann D, Morgan SJ, Kim J, Hafner BJ. Health-Related Profiles of People With Lower Limb Loss. Archives of Physical Medicine and Rehabilitation. 2015;96:1474?83.
28. Karmarkar AM, Graham JE, Reistetter TA, Kumar A, Mix JM, Niewczyk P, et al. Association between Functional Severity and Amputation Type with Rehabilitation Outcomes in Patients with Lower Limb Amputation. Rehabilitation Research and Practice. 2014;2014:1?7.
29. Pande SD, Kamal A, Zaw E, Tin AS. Patients following lower limb amputation: A retrospective cohort study showing how to improve survival and rehabilitation outcomes. International Journal of Surgery Open. 2019;20:24?8.
30. Meulenbelt HEJ, Geertzen JHB, Jonkman MF, Dijkstraa PU. Skin Problems of the Stump in Lower Limb Amputees: 2. Influence on Functioning in Daily Life. Acta Dermato-Venereologica. 2011;91:178?82.
31. Cazabon L, Casillas JM, Ader P, Grumler B, Lothe M, Dulieu V. Appareillage précoce par manchon silicone avec attache terminale après amputation vasculaire sous le genou?: évaluation par score de marche du devenir fonctionnel. Annales de Réadaptation et de Médecine Physique. 2005;48:118?25.
32. Jomli R, Abdelghaffar W, Ben Zineb S, Ouali U, Zgueb Y, Nacef F, et al. Évaluation de la qualité de vie chez des personnes handicapées. Journal de Réadaptation Médicale?: Pratique et Formation en Médecine Physique et de Réadaptation. 2015;35:143?53.
33. Ghoseiri K, Allami M, Soroush MR, Rastkhadiv MY. Assistive technologies for pain management in people with amputation: a literature review. Mil Med Res. 2018;5:1.
34. Richardson C, Olleveant N, Crawford K, Kulkarni J. Exploring the Role of Cortical Reorganization in Postamputation Phantom Phenomena, Including Phantom Limb Pain in Lower Limb Amputees: A Cross-Sectional Study of the Patterns of Referral of Sensations into the Phantom. Pain Management Nursing. 2018;19:599?607.
35. Richardson C, Crawford K, Milnes K, Bouch E, Kulkarni J. A Clinical Evaluation of Postamputation Phenomena Including Phantom Limb Pain after Lower Limb Amputation in Dysvascular Patients. Pain Management Nursing. 2015;16:561?9.
36. Richardson C, Glenn S, Horgan M, Nurmikko T. A Prospective Study of Factors Associated With the Presence of Phantom Limb Pain Six Months After Major Lower Limb Amputation in Patients With Peripheral Vascular Disease. The Journal of Pain. 2007;8:793?801.
37. Sinha R, van den Heuvel WJ, Arokiasamy P. Factors affecting quality of life in lower limb amputees. Prosthetics and orthotics international. 2011;35:90?6.
38. Pedras S, Vilhena E, Carvalho R, Pereira MG. Psychosocial adjustment to a lower limb amputation ten months after surgery. Rehabilitation Psychology. 2018;63:418?30.
39. Riis Madsen U. Quality of life, functional level and needs of care after vascular major lower limb amputation. [Lund]: Lund University; 2017.
40. Endoh S, Yamana H, Nakahara Y, Matsui H, Fushimi K, Yasunaga H, et al. Risk Factors for In-hospital Mortality and Reamputation Following Lower Limb Amputation. Prog Rehabil Med. 2017;2:20170015.
41. Furtado S, Grimer RJ, Cool P, Murray SA, Briggs T, Fulton J, et al. Physical functioning, pain and quality of life after amputation for musculoskeletal tumours. The Bone & Joint Journal. 2015;97-B:1284?90.
42. Matos DR, Naves JF, Araujo TCCF de. Quality of life of patients with lower limb amputation with prostheses. Estud psicol (Campinas) [Internet]. 2019 [cité 15 mai 2022];37. Disponible sur: http://www.scielo.br/j/estpsi/a/5f99wPx4NP5wxJyvYBrv8sJ/?format=html&lang=en
43. Christensen J, Ipsen T, Doherty P, Langberg H. Physical and social factors determining quality of life for veterans with lower-limb amputation(s): a systematic review. Disabil Rehabil. 2016;38:2345?53.
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