OUTCOME

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OUTCOME COST ANALYSIS OF PHYSIOTHERAPIST
MANUFACTURED TEMPORARY PROSTHESES
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• 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

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• 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

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• 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)

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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

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• Reason for dropout
• 2 deceased
• 1 straight to definitive
• 2 medical reasons
• 2 AKAs withdrew as too hard
• 1 t/f out of area, data lost

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

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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

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Preliminary Outcome Data

• Reason for amputation
• Cancer 2
• Diabetes 4
• Orthopaedic 1
• PVD 14
• Trauma 1
• Other 2 (inotropic complications)

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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

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Preliminary Outcome Data

• Amputation to Temporary
• Range 28 to 1355
• Avg 121.9days (65 days without outlier)
• Reasons for delay
• Healing 11 - Staff couldnt make 3
• Falls 3 - Medical 1
• Emotional 1 - Ulcer other foot 1
• Waiting list 2 - Init didnt want 1

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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.

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Preliminary Outcome Data

• Amputation to Definitive (20)
• Range 87 to 262 days
• Avg 162 days (5 ½ months)

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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

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Preliminary Outcome Data

• Discharge independence (19)
• Independent 15
• Supervision 2
• SB assist 1
• Assistance 1

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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

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Preliminary Outcome Data

• 2 minute walk results (12)
• Range 24m to 135m
• Avg 70m
• Avg AKA 46.2m
• Avg BKA 79.6m

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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