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OUTCOME & COST ANALYSIS OF PHYSIOTHERAPIST MANUFACTURED TEMPORARY PROSTHESES

OUTCOME & COST ANALYSIS OF PHYSIOTHERAPIST MANUFACTURED TEMPORARY PROSTHESES. Multi-centre data collection AKA & BKA Started June 2005, collection to June 2007 Hypothesis:

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OUTCOME & COST ANALYSIS OF PHYSIOTHERAPIST MANUFACTURED TEMPORARY PROSTHESES

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  1. OUTCOME & COST ANALYSIS OF PHYSIOTHERAPIST MANUFACTURED TEMPORARY PROSTHESES

  2. Multi-centre data collection • AKA & BKA • Started June 2005, collection to June 2007 • Hypothesis: The use of temporary prostheses will provide a safe, cost-effective, and efficient means of rehabilitating lower limb amputees

  3. Effectiveness • Time to temporary & definitive • Time to discharge • Complications such as wound breakdown • Who made the temporary – expert/novice • Number of temporaries to definitive • Time to 2nd definitive socket (if in data collection period) • Occasions of temporary prosthetic failure & patient weight

  4. Outcome • Time to definitive • Discharge date • Discharge destination • Aids • 10m walk time • 2 min walk • Level of independence • Stairs ability • Bed mobility (acute setting – time to first mobilise)

  5. Where Are We? • Number of recruits: • Bankstown 13 • Prince Henry 7 • Nepean 17 • Blue Mountains 4 • Liverpool 27 • Port Kembla 18 • Westmead 10? (before interim project) • Dropouts 8 • Total 88

  6. Reason for dropout: • 2 deceased • 1 straight to definitive • 2 medical reasons • 2 AKA’s withdrew as too hard • 1 t/f out of area, data lost

  7. Adverse Events • 2 cracks in plaster • 1 blister where did not adjust socks • 1 screw loose & fell down stairs

  8. Preliminary Outcome Data • 22 clients, 24 limbs. • Avg age = 66 • Sex: • 16 male • 6 female • Level • AKA = 10 • BKA = 10 • Bilat BKA (at same time) = 2

  9. Preliminary Outcome Data • Reason for amputation: • Cancer 2 • Diabetes 4 • Orthopaedic 1 • PVD 14 • Trauma 1 • Other 2 (inotropic complications)

  10. Preliminary Outcome Data • Co-morbidities: • DM 10 • Cardiac 9 • Respiratory 1 • PVD 15 • Cognitive 0 • CVA 3 • Emotional 3 • Amp other leg (earlier) 1 • Hep C 1 • OA knee 1 • Hypotension 1 • Epilepsy 1

  11. Preliminary Outcome Data • Amputation to Temporary: • Range = 28 to 1355 • Avg = 121.9days (65 days without outlier) • Reasons for delay: • Healing 11 - Staff couldn’t make 3 • Falls 3 - Medical 1 • Emotional 1 - Ulcer other foot 1 • Waiting list 2 - Init didn’t want 1

  12. Preliminary Outcome Data • Temporary to definitive: (20 legs) • Range 52 to 202 days • Avg 102 days • 2 AKA withdrew before definitive • 2 AKA 2nd socket within 6 months due to weight gain ~10kg each.

  13. Preliminary Outcome Data • Amputation to Definitive: (20) • Range 87 to 262 days • Avg 162 days (5 ½ months)

  14. Preliminary Outcome Data • Discharge data: (19 clients) • Aids: • 1 crutch 1 • 2 crutches 1 • 2 sticks 3 • Nil 6 • PUF 3 • Rollator 3 • W/c 2

  15. Preliminary Outcome Data • Discharge independence: (19) • Independent 15 • Supervision 2 • SB assist 1 • Assistance 1

  16. Preliminary Outcome Data • 10m walk times (13) • Range 6 to 52 sec • Avg = 18.2 sec • Avg AKA = 25.8 sec • Avg BKA = 14.6 sec

  17. Preliminary Outcome Data • 2 minute walk results (12): • Range 24m to 135m • Avg = 70m • Avg AKA = 46.2m • Avg BKA = 79.6m

  18. Where to From Here? • 7 months to go. • Target (100 recruits) looks achievable. • Tidy up missing data. • Full analysis of data • ??Publish • Implications of TGA changes

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