To lump or to split? Comparing individuals with traumatic and nontraumatic limb loss in the first year after amputation.
OBJECTIVE
To compare individuals with traumatic (TE) vs. nontraumatic (NTE) amputation etiology on pain, psychological, and social variables over the first 12 months postamputation, and to explore changes in mean levels of and correlations between these variables over time.


METHODS
There were 111 adults with newly acquired limb loss.


METHODS
A VA medical center and a Level I trauma hospital in a large metropolitan area.


METHODS
Characteristic Pain Severity, Pain Interference, Patient Health Questionnaire depression module, Posttraumatic Stress Disorder Checklist, Social Constraints Scale, Aversive Emotional Support Scale, Centers for Disease Control and Prevention single item Social Support measure, single item loneliness measure.


RESULTS
The NTE group was significantly older, had lower income, and had greater medical comorbidity, preamputation pain, and physical disability. The etiology groups did not differ significantly in mean levels of outcome variables except that the TE group reported greater aversive emotional support at 6 and 12 months. The TE group demonstrated a quadratic change in pain interference, with highest levels at 6 months and a linear increase in social constraints. Both etiology groups showed a linear increase in PTSD symptoms over time. Correlations between physical, psychological, and social distress were observed earlier in the year for the NTE group.


CONCLUSIONS
Despite significant demographic and preamputation experience differences, few differences in outcomes emerged by etiology group in the first year after amputation. Findings suggest that the year after amputation may be a time of greater change for those with traumatic amputation compared to those with nontraumatic amputation.
Kratz
Anna L
AL
Department of Rehabilitation Medicine, University of Washington, USA.
Williams
Rhonda M
RM
Turner
Aaron P
AP
Raichle
Katherine A
KA
Smith
Doug G
DG
Ehde
Dawn
D
D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000671:Amputation, Surgical / Q000523:psychology; D000673:Amputation, Traumatic / Q000150:complications* / Q000523:psychology*; D004185:Disability Evaluation; D005121:Extremities / Q000293:injuries*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010147:Pain Measurement; D011184:Postoperative Period; D012720:Severity of Illness Index; D012917:Social Adjustment; D012944:Social Support; D012959:Socioeconomic Factors; D013240:Stereotyping; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D055815:Young Adult