Assessment of Quality of Life Among Moroccan Patients with Major Lower Limb Amputation: A Cross-Sectional Study

Abstract

Background & objectives: Despite advances in awareness and prevention the major amputation of the lower limb. MLLA is expanding and contributing to a significant disease burden in both developed and developing countries. The aim of this research was to explore the influence of major lower limb amputation (MLLA) on the quality of life (QOL) of Moroccan patients in the immediate postoperative period and three months after discharge. Materials and methods: Prospective observational study assessing the QOL of patients with MLLA during the 48 hours following the amputation procedure and three months after discharge, using the Arabic version of SF-12 quality of life questionnaire. Results: The study included 101 patients in the first assessment during the 48 hours following the amputation (T0), and 86 patients were included in the second assessment three months after discharge (T1). The mean age of patients with MLLA was 59.3 ± 16 years with a male predominance (70.3%). The main cause of MLLA was diabetic foot (47.5%). The mean global score of the SF-12 at T0 and T1 were 31.93±6.91 and 39.58±5.19 respectively. The physical component summary (PCS) was significantly lower than the mental component summary (MCS) at T0 and at T1, but a significant increase (p<0.001) of PCS and MCS was seen in patients with MLLA at T1. In multivariate regression the independents factors associated with lower PCS were limitation of mobility, age, general anaesthesia, length of hospital stay, reamputation and stump pain. While total mobility assistance, partial mobility assistance, length of hospital stay, peripheral nerve block and heart disease had a negative impact on the MCS of patients with MLLA.Conclusion: Patients with a MLLA had a poor QOL in terms of both physical and mental health. Limitation of mobility, advanced age, type of anaesthesia, stump pain, reamputation and heart disease appear to be risk factors for poor QOL. Young age, male gender, absence of comorbidity, information and explanation of the amputation procedure to the patient, absence of stump pain, early mobility and fitting are factors related to good QOL.