• Raymond Cheng, Sean Smith, and Claire Z Kalpakjian.
• Physical Medicine and Rehabiltation, Medical Center Arlington, 76015 Arlington, USA. rayscheng@gmail.com.
• J Rehabil Med. 2019 May 13; 51 (5): 369-375.

ObjectiveTo examine how factors associated with infection, organ failure, poor wound healing, or indices of chronic vascular disease are associated with unplanned transfers and functional gains in a population of dysvascular amputees during inpatient rehabilitation.DesignCross-sectional.SettingInpatient rehabilitation unit at an academic medical centre.PatientsA total of 118 patients with new, dysvascular, lower-extremity, amputation participating in inpatient rehabilitation.MethodsLogistic regression and indices of change (minimal detectable change; MDC90), standardized response mean and effect size were used to examine the risks of unplanned transfer and functional change.Main Outcome MeasurementsRate of unplanned transfers from rehabilitation, and Functional Independence Measure (FIM).ResultsOut of the total of 118 patients 19 had unplanned transfers due to medical complications. Age, creatinine, haemoglobin, white blood cell count, haemodialysis, wound vacuum device use, intravenous antibiotic use, or previous amputations were not independently associated with unplanned transfers, motor FIM change or efficiency. The MDC90 for motor FIM was 17.84, with 21.2% of patients exceeding this value; standardized response mean and effect size were large (1.03 and 1.39, respectively).ConclusionThis study suggests that the presence of comorbidities in a population of dysvascular amputees participating in inpatient rehabilitation did not increase the risk of unplanned transfers or affect FIM gains.

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