Risk of fall-related injury in people with lower limb amputations: A prospective cohort study.

OBJECTIVE To assess fall-related injury risk and risk factors in people with lower limb amputation. DESIGN Prospective longitudinal cohort with follow-up every 6 months for up to 41 months. SUBJECTS Community-dwelling adults with lower limb amputations of any etiology and level recruited from support groups and prosthetic clinics. METHODS Demographic and clinical characteristics were obtained by self-reported questionnaire and telephone or in-person follow-up. Fall-related injury incidence requiring medical care per person-month and adjusted hazard ratio of fall-related injury were calculated using multivariable proportional hazards regression modeling. RESULTS A total of 41 subjects, with 782 follow-up person-months in total, had 11 fall-related injury incidents (14.1/1,000 person-months). During follow-up, 56.1% of subjects reported falling and 26.8% reported fall-related injury. Multivariable proportional hazard modeling showed that women were nearly 6 times more likely as men to experience fall-related injury and people of non-white race were 13 times more likely than people of white race to experience fall-related injury. The final predictive model also included vascular amputation and age. CONCLUSION Risk of fall-related injury requiring medical care in people with lower limb amputation appears to be higher than in older adult inpatients. Intervention programs to prevent fall-related injury in people with lower limb amputation should target women and racial minorities.