The impact of gender, level of amputation and diabetes on prosthetic fit rates following major lower extremity amputation

Background: Diabetes Mellitus (DM) is a leading cause of major lower extremity amputation (LEA). Objective: To examine the influence of gender, level of amputation and DM status on being fit with a prosthetic limb following LEA. Study Design: Retrospective analysis of the SPARG dataset. Results: Within the cohort (n=1735) 64% were men (n=1112) and 48% (n=834) had DM. Those with DM were younger than those without: mean 67.5 years and 71.1 years respectively (p<0.001). Trans-Tibial Amputation (TTA): Trans-Femoral Amputation (TFA) ratio was 2.33 in those with DM, and 0.93 in those without. 41% of those with DM were successfully fit with a prosthetic limb compared to 38% of those without DM. Male gender positively predicted fitting with a prosthetic limb at both TTA (p=0.001) and TFA (p=0.001) levels. Bilateral amputations and increasing age were negative predictors of fitting with a prosthetic limb (p<0.001). DM negatively predicted fitting with a prosthetic limb at TFA level (p<0.001). Mortality was 17% for the cohort, 22% when the amputation was at TFA level. Conclusion: Those with DM were younger, with more TTA, both are good predictors of fitting with a prosthetic limb, despite this, successful limb fit rates were no better than those without DM