Quality of Life in Amputated Patients Based on Social Deprivation Factors

Amputation remains an important treatment option for patients with sarcoma. While limb salvage procedures have become more widely utilized after the advent of chemotherapy, some patients still require amputation in the management of their disease. Studies have shown that patients with social deprivation factors are at higher risk of presenting with advanced disease, and thus are at increased risk of requiring definitive amputation1-3. Additional research shows amputations are more common in lower socioeconomic status patients4. Whether these procedures are done for trauma or infection, they can have morbid outcomes. Prior literature demonstrates that long-term healthcare costs after amputation are higher than in limb salvage5,6. In some patients, the costs associated with prosthetics may be prohibitive and thus impact quality of life. While many factors are thought to ultimately impact life after amputation7, it remains unclear how social deprivation affects outcomes in patients who undergo an amputation.

Data Collection: Under an approved HIPAA waiver, dependent and independent variables will be collected and retrospectively from a chart review. After we receive the initial request, we will perform a chart review to ensure inclusion/exclusion criteria was met. The following information will be obtained through a combination of the report request and subsequent chart review:

• Demographic Information: Name, MRN, Age, Gender, Insurance Status (private v Medicaid v Medicare v uninsured), Address (including Zip Code), Sarcoma Diagnosis, Amputation Level and Date, Medical Comorbidities
• Survey Information: Current work status and Occupation, Race, Education Level (Highest level degree obtained), Use of prosthesis (and why not if answer is No), Prosthesis Information if yes (Manufacturer and Model), SF-36 Questionnaire, MSTS Tumor Score Questionnaire, Prosthesis Evaluation Questionnaire-Mobility Section (PEQ-MS)

In addition to chart review, subjects will also complete a series of questionnaires to assess outcomes related to surgery. The questionnaires include SF-36 Questionnaire, MSTS Tumor Score Questionnaire, and Prosthesis Evaluation Questionnaire-Mobility Section (PEQ-MS). Prior to contact, subjects will receive a letter (waiver of documentation of informed consent) from the attending physicians describing the study and asking them if they would like to participate in the study by completing the questionnaires and allowing the use of their data for the study. The letter from the attending physicians will also explain that subjects will receive an email or telephone call from a research team member. Subjects will have the opportunity to complete the questionnaire via phone, regular mail, or email using the survey function in RedCap.

Subjects that are willing to complete the questionnaire will be enrolled under a waiver of documentation of informed consent. Subjects that are not willing to complete the questionnaire but will allow their data to be used will be enrolled under a waiver of documentation of informed consent (i.e.: Subject states on the phone they don't want to complete questionnaire, but they give permission for us to retrospectively use their data). Those subjects that have inadequate data or cannot be reached after a reasonable effort will be enrolled under a full waiver of informed consent to use their retrospective data. If subjects indicate on the phone or via email, they do not want their retrospective data used we will withdraw the subject and delete all retrospective data.