Bowrey et al reported the BLARt score for evaluating the functional outcome for a lower limb amputation. The authors are from the University of Leicester, Leicester Royal Infirmary and the Leicester Specialist Mobility Centre in England.
BLARt stands for Blatchford Allman Russell tool.
Patient selection: lower limb amputee >= 14 years of age
Outcome: SIGAM grade B or below at 12 months (F indicates normal or near normal walking)
Parameters:
(1) sex
(2) age in years
(3) body mass index (BMI) in kg per sq m
(4) mobility before amputation
(5) special risks (5 conditions)
(6) indication for amputation
(7) level of amputation
(8) cognitive impairment
|
Parameter |
Finding |
Points |
|
sex |
male |
0 |
|
|
female |
1 |
|
age in years |
14 to 49 years |
0 |
|
|
50 to 64 years |
1 |
|
|
65 to 74 years |
2 |
|
|
75 to 80 years |
5 |
|
|
> 80 years |
6 |
|
BMI |
< 18.5 |
2 |
|
|
18.5 to 24.9 |
0 |
|
|
25 to 29.9 |
1 |
|
|
>= 30 |
3 |
|
mobility before amputation |
able to walk >= 3 miles |
0 |
|
|
unaided outside mobility |
1 |
|
|
outdoor mobility with aids |
2 |
|
|
indoor mobility with aids |
3 |
|
|
wheelchair bound < 12 months |
4 |
|
|
wheelchair bound >= 12 months |
5 |
|
severe respiratory disease |
no |
0 |
|
|
yes |
5 |
|
requires dialysis |
no |
0 |
|
|
yes |
4 |
|
stroke |
no |
0 |
|
|
yes |
3 |
|
recent AMI or angina |
no |
0 |
|
|
yes |
2 |
|
contralateral limb problem |
no |
0 |
|
|
underlying claudication, ulcer or knee replacement |
2 |
|
|
toe or partial foot; difficult weight bearing |
3 |
|
|
previous amputation or severe illness; unable to bear weight |
4 |
|
indication for amputation |
trauma |
0 |
|
|
congenital cause |
0 |
|
|
cancer |
1 |
|
|
orthopedic |
2 |
|
|
vascular |
3 |
|
level of amputation |
unilateral transfemoral or through knee |
3 |
|
|
unilateral transtibial |
1 |
|
|
hip disarticulation |
5 |
|
|
bilateral transtibial |
4 |
|
|
transtibial with contralateral transfemoral or through knee |
5 |
|
|
bilateral transfemoral or through-knee amputation |
6 |
|
cognitive status |
alert and aware |
0 |
|
|
limited carry over |
3 |
|
|
confused |
5 |
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 47
• No patient with a score >= 13 was able to walk independently.
• No patient with a score >= 22 was able to walk to any degree.
Performance:
• The area under the ROC curve is 0.91.
