Venous thromboembolism in a rehabilitation setting after major lower-extremity amputation

Objective: To determine the prevalence of venous thromboembolic disease (VTED) and impact on functional outcome in patients with major lower-extremity (LE) amputation admitted to an inpatient rehabilitation unit. Design: Retrospective medical records review. Setting: Acute inpatient rehabilitation unit in a tertiary, urban academic medical center. Participants: Fifty consecutive patients admitted to an acute inpatient rehabilitation unit after a major LE amputation. Participants were screened at rehabilitation admission for LE deep vein thrombosis using duplex ultrasonography. Interventions: Not applicable. Main Outcome Measures: VTED incidence. FIM instrument, total rehabilitation charges, and length of stay (LOS). Results: Six of 50 patients (12%) had evidence of VTED. The VTED cohort had significantly lower admission and discharge FIM scores than the no-VTED cohort (admission FIM score, 57.2 vs 76.0; discharge FIM score. 66.0 vs 90.1, respectively; Pless than or equal to.02). Subjects with VTED had a longer rehabilitation LOS (22.8d vs 13.9d. respectively; P=.02) and higher total rehabilitation charges ($28,314 vs $17,724, respectively; P<.05). Conclusions: In this study, VTED prevalence after LE amputation in a rehabilitation setting was 12%. Subjects with VTED had lower admission and discharge functional status, longer LOS, and higher hospital charges. The utility of screening duplex ultrasound examinations at rehabilitation admission remains unclear.