title: Dismounted complex blast injuries: patterns of injuries and resource utilization associated with the multiple extremity amputee.
abstract: The objective of this report is to analyze the resource utilization and injury patterns of complex dismounted blast injuries. A retrospective review of U.S. service members injured in combat between 2007 and 2010 was conducted. Data analyzed included age, injury mechanism, amputated limbs, number and type of associated injuries, blood products utilized, intensive care unit length of stay (ILOS), hospital length of stay (HLOS) and the Injury Severity Score (ISS). Patients were stratified based on the number of amputations. Sixty-three patients comprised the multiple extremity amputation (MEA) group. Ninety-eight percent sustained injuries from an improvised explosive device (IED) and 96% were dismounted. The ISS, number of surgical encounters, blood products utilized and ILOS were all clinically significantly different than controls. Care of multiple extremity amputees involves the utilization of significant resources. This knowledge may better help surgeons and administrators allocate assets at hospitals, both military and civilian, who care for this complex and challenging patient population.
authors.affiliation: Department of Orthopedics and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA. Mark.Fleming@med.navy.mil
authors.forename: Mark
authors.initials: M
authors.lastname: Fleming
authors.forename: Scott
authors.initials: S
authors.lastname: Waterman
authors.forename: James
authors.initials: J
authors.lastname: Dunne
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: D'Alleyrand
authors.forename: Romney C
authors.initials: RC
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000453:epidemiology* / Q000628:therapy; D001753:Blast Injuries / Q000453:epidemiology* / Q000628:therapy; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D055815:Young Adult