Article

National Trauma Databank analysis - The purpose of this study was to examine the epidemiology and outcomes of
posttraumatic upper (UEA) and lower extremity amputations (LEA). The National
Trauma Databank version 5 was used to identify all posttraumatic amputations.
From 2000 to 2004 there were 8910 amputated patients (1.0% of all trauma
patients). Of these, 6855 (76.9%) had digit and 2055 (23.1%) had limb amputation.
Of those with limb amputation, 92.7 per cent (1904/2055) had a single limb
amputation. LEA were more frequent than UEA among patients in the single limb
amputation group (58.9% vs 41.1%). The mechanism of injury was blunt in 83 per
cent; most commonly after motor vehicle collisions (51.0%), followed by machinery
accidents (19.4%). Motor vehicle collision occupants had more UEA (54.5% vs
45.5%, P < 0.001), whereas motorcyclists (86.2% vs 13.8%, P < 0.001) and
pedestrians (91.9% vs 8.1%, P < 0.001) had more LEA. Patients with LEA were more
likely to require discharge to a skilled nursing facility; whereas those with UEA
were more likely to be discharged home. Traumatic limb amputation is not uncommon
after trauma in the civilian population and is associated with significant
morbidity. Although single limb amputation did not impact mortality, the need for
multiple limb amputation was an independent risk factor for death.

Langue : ANGLAIS

Tiré à part : OUI