title: Epidemiology of post-traumatic limb amputation: a National Trauma Databank analysis.
abstract: 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.
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, University of Southern California, Los Angeles, California 90033, USA.
authors.forename: Galinos
authors.initials: G
authors.lastname: Barmparas
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
authors.forename: Pedro G R
authors.initials: PG
authors.lastname: Teixeira
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Dubose
authors.forename: Michele
authors.initials: M
authors.lastname: Criscuoli
authors.forename: Peep
authors.initials: P
authors.lastname: Talving
authors.forename: David
authors.initials: D
authors.lastname: Plurad
authors.forename: Donald
authors.initials: D
authors.lastname: Green
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D001794:Blood Pressure; D016009:Chi-Square Distribution; D003710:Demography; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D035002:Lower Extremity / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D034941:Upper Extremity / Q000293:injuries* / Q000601:surgery*