Increased cardiovascular disease mortality rates in traumatic lower limb amputees

Modan, Michaela; Peles, Einat; Halkin, Hillel; Nitzan, H.; Azaria, M; Gitel, Sanford N.; Dolfin, Dan; Modan, Baruch

doi:10.1016/s0002-9149(98)00601-8

Cited by 81 publications

(77 citation statements)

References 21 publications

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“…In the present study, the number or location of amputations did not correlate with HRV; however, Modan et al have related proximity and number of amputations to higher CV risk [24]. Note: p-values show absence of significant differences among PLP and no PLP groups.…”

Section: Discussioncontrasting

confidence: 69%

Heart rate variability and phantom pain in male amputees: Application of linear and nonlinear methods

Cachadiña¹,

García²,

Luz³

et al. 2013

JRRD

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Abstract-Phantom-limb pain (PLP) is a phenomenon that may appear among people with amputation. Some studies reveal that 70% of people with amputation experience PLP years postamputation. There is a lack of scientific evidence about the cause of PLP. It has been hypothesized that the autonomic nervous system (ANS) could be involved in the mechanism that triggers PLP, but this hypothesis remains unclear. The aim of this study was to correlate ANS function, through heart rate variability (HRV) analysis, with PLP in adult males with amputation. The study population comprised 35 subjects, with 27 reporting PLP often or always. The rest of the subjects did not report any PLP. In order to calculate linear and nonlinear parameters of HRV, all subjects underwent 10 min of resting heart rate monitoring. The study did not find correlations between HRV parameters and PLP. Most of the subjects showed decreased values in linear parameters of HRV while nonlinear values were normal. HRV is not implicated in PLP. Linear and nonlinear methods for HRV analysis might reflect different physiological phenomena; while linear values place people with amputation at cardiovascular risk, nonlinear values indicate normality.

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Section: Discussioncontrasting

confidence: 69%

Heart rate variability and phantom pain in male amputees: Application of linear and nonlinear methods

Cachadiña¹,

García²,

Luz³

et al. 2013

JRRD

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“…The cutoff value of UAC shows higher degree of agreement for the diagnosis of CVD risk than the cutoff value of WC (for Asian population) as used in the standard literatures, indicating better CVD risk diagnostic ability of UAC for the individuals with traumatic LEA. It is worthwhile to mention that the individuals with LEA are in a greater risk of developing CVD owing to their poor physical activity level (Madan et al, 1998;Resnick et al, 2004). They need diagnosis of CVD risk well in advance for proper medical care and management of the diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Cross-sectional studies also reveal higher prevalence of CVD risk factors among individuals with LEA (Madan et al, 1998;Resnick et al, 2004). Again, Resnick et al (2004) reported that the risk of developing CVD is more among individuals with amputation owing to peripheral vascular disease, but the individuals with traumatic amputation also show high mortality owing to CVD (Madan et al, 1998). In a follow-up study among traumatic amputees, Hrubec and Ryder (1980) showed that the differential mortality rate owing to CVD varies depending on the site of amputation, and the mortality rate owing to CVD is higher in the individuals with proximal limb amputation than in the individuals with distal limb amputation.…”

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Validity of an alternative anthropometric trait as cardiovascular diseases risk factor: example from individuals with traumatic lower extremity amputation

Mozumdar

2006

Eur J Clin Nutr

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Background: Published studies reveal that individuals with lower extremity amputation are vulnerable to cardiovascular diseases (CVD) because of poor physical activity level. Many cardiovascular risk assessment studies have utilized anthropometric traits (primarily body mass index and waist circumference) as cardiovascular risk factor. However, some studies emphasized the technical limitations of measuring waist circumference for studying cardiovascular risk, and so it is difficult to obtain correct measurement from the individuals with lower extremity amputation. Objectives: The objectives of the present article are to study the prevalence of CVD risk factors among the individuals with traumatic lower extremity amputation and to test the validity of upper arm circumference (UAC) as an alternative anthropometric measurement for screening the CVD risk condition. Subjects and setting: Anthropometric data and other cardiovascular traits data have been collected from unilateral traumatic lower extremity amputated adult males (n ¼ 85) residing in Calcutta and adjoining areas. Results: Results show higher prevalence of cardiovascular risk factor among individuals with above-knee amputation than below-knee amputation. The receiver operating characteristics curve analysis shows significant ability of upper arm circumference to diagnose cardiovascular risk condition. The cutoff value of UAC426.6 cm show maximum sensitivity and specificity for the diagnosis of cardiovascular risk condition. Although, binomial tests for equality of proportion does not show any significant difference, however, agreement statistics reveal better diagnostic ability of cutoff value of UAC than the existing cutoff value of waist circumference. Conclusions: Therefore, UAC provides a better assessment of cardiovascular risk condition than does waist circumference especially for individuals with lower extremity amputation.

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“…Excess body weight is a major concern for people with a lower-limb amputation (LLA) because it can have numerous deleterious consequences, including an increased risk of musculoskeletal pain, osteoarthritis, cardiovascular disease, falls and other injuries, impaired functional capacity, reduced prosthesis fit and function, and a diminished quality of life [4][5][6][7][8]. These consequences can in turn result in reduced activity levels and a cascade of events such as increased wheelchair use, a more sedentary lifestyle, greater healthcare utilization and costs, reduced ability to live independently, and increased burden on formal and informal caregivers [7][8].…”

Section: Introductionmentioning

confidence: 99%

Lower-limb amputation and body weight changes in men

et al. 2015

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Abstract-Little is known about the relationship between lower-limb amputation (LLA) and subsequent changes in body weight. We conducted a retrospective cohort study using clinical and administrative databases to identify and follow weight changes in 759 males with amputation (partial foot amputation [PFA], n = 396; transtibial amputation [TTA], n = 267; and transfemoral amputation [TFA], n = 96) and 3,790 men without amputation frequency-matched (5:1) on age, body mass index, diabetes, and calendar year from eight Department of Veterans Affairs medical care facilities in the Pacific Northwest. We estimated and compared longitudinal percent weight change from baseline up to 39 mo of follow-up in men with and without amputation. Weight gain in the 2 yr after amputation was significantly more in men with an amputation than without, and in men with a TTA or TFA (8%-9% increase) than in men with a PFA (3%-6% increase). Generally, percent weight gain peaked at 2 yr and was followed by some weight loss in the third year. These findings indicate that LLA is often followed by clinically important weight gain. Future studies are needed to better understand the reasons for weight gain and to identify intervention strategies to prevent excess weight gain and the deleterious consequences that may ensue.

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Increased cardiovascular disease mortality rates in traumatic lower limb amputees

Cited by 81 publications

References 21 publications

Heart rate variability and phantom pain in male amputees: Application of linear and nonlinear methods

Heart rate variability and phantom pain in male amputees: Application of linear and nonlinear methods

Validity of an alternative anthropometric trait as cardiovascular diseases risk factor: example from individuals with traumatic lower extremity amputation

Lower-limb amputation and body weight changes in men

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