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The effect of depression on prosthesis prescription in men and women who have undergone a lower limb amputation.
- Source :
- Disability & Rehabilitation; Mar2024, Vol. 46 Issue 6, p1204-1211, 8p
- Publication Year :
- 2024
-
Abstract
- To determine gender disparities and potential factors that modify prosthesis prescription practices in veteran patients who have undergone their first major unilateral amputation due to diabetes or peripheral arterial disease. A retrospective cohort study using the VA Corporate Data Warehouse to compare prosthesis prescription rates and time to prescription between men and women veterans. The primary exposure was gender. The primary outcome was a qualifying prosthesis prescription within 12 months of the incident amputation. The secondary outcome was time to prosthesis prescription. Multiple logistic and linear regression was used to control for potential confounders and identify potential effect modification. 2,862 individuals met study criteria, with 1690 (60%) prescribed a qualifying prosthesis. Men were more likely to receive a prosthesis prescription than women (59% versus 45%, respectively; p = 0.03). This difference was observed primarily among those with a diagnosis of major depressive disorder. In this subgroup, the odds of men receiving a prosthesis over women was over 3 times (adjusted odds ratio = 3.3; 95% Confidence Interval, 1.5, 7.4). Men had a mean shorter time to prescription compared to women (112 ± 72 versus 136 ± 79 days, respectively, p = 0.08). Depression in women negatively impacts their prosthesis prescription rates and time to prescription compared to men. This disparity may have significant impacts on future function and quality of life. This study found that men more commonly received a prosthesis prescription and received it earlier than women. This disparity was most extreme among women who had been diagnosed with major depressive disorder. Providers should identify at risk patients early and consider targeted interventions to address depression during the preoperative and immediate postoperative phases. Future research should continue to work to identify gender-specific needs that exacerbate disparity. [ABSTRACT FROM AUTHOR]
- Subjects :
- LEG surgery
AMPUTATION
ARTIFICIAL limbs
THERAPEUTICS
SURGERY
PATIENTS
T-test (Statistics)
RESEARCH funding
DIABETIC neuropathies
PERIPHERAL vascular diseases
SEX distribution
MULTIPLE regression analysis
RETROSPECTIVE studies
DESCRIPTIVE statistics
CHI-squared test
PSYCHOLOGY of veterans
LONGITUDINAL method
DISARTICULATION
ODDS ratio
MEDICAL records
ACQUISITION of data
STATISTICS
COMPARATIVE studies
CONFIDENCE intervals
SOCIODEMOGRAPHIC factors
DATA analysis software
MENTAL depression
TIME
REHABILITATION
Subjects
Details
- Language :
- English
- ISSN :
- 09638288
- Volume :
- 46
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Disability & Rehabilitation
- Publication Type :
- Academic Journal
- Accession number :
- 176073578
- Full Text :
- https://doi.org/10.1080/09638288.2023.2192976