The risk of major cardiovascular events for adults with transfemoral amputation.
Benjamin F Mundell, Marianne T Luetmer, Hilal Maradit Kremers and 3 others
PMID 30255813WHAT IT FOUND
Overall, adults with transfemoral amputation were no more likely to have a major cardiovascular event than matched controls, but those with dysvascular amputation had a four-fold higher risk.
Prosthesis was not associated with a difference in cardiovascular event risk.
Key findings
01Overall, adults with transfemoral amputation were no more likely to experience a major cardiovascular event than matched controls.
02Dysvascular transfemoral amputation was associated with an approximately four-fold increase in major cardiovascular event risk before and after 2.5 years post-amputation.
03Receipt of a prosthesis was not associated with a difference in major cardiac event risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was done in Olmsted County, Minnesota, a population described as less diverse, wealthier, and more highly educated than the general U.S. population. Only 162 adults with transfemoral amputation were studied, and the trauma or cancer group was only 55 people. The design was observational, so it cannot prove that amputation or prosthesis receipt caused the risk differences. The lower death risk seen with prosthesis receipt likely reflects that people had to survive long enough to receive a prosthesis, and the data made this hard to account for.
Declared interests
No author conflict-of-interest declaration is included in the supplied text. The article is marked as supported by N.I.H. extramural research and non-U.S. government research.
The easy way to misread this
Do not read the prosthesis finding as proof that prosthetic care reduces cardiovascular risk. The study found no difference in major cardiac events, and the lower death risk likely reflects that patients had to survive long enough to receive a prosthesis.