A Comparison of Four-Year Health Outcomes following Combat Amputation and Limb Salvage

Autor: Vibha Bhatnagar, Michael R. Galarneau, Erin Richard, Ted Melcer, V. Franklin Sechriest, Jay Walker
Jazyk: angličtina
Rok vydání: 2017
Předmět:
myalgia
Male
Bacterial Diseases
Time Factors
Critical Care and Emergency Medicine
Traumatic Brain Injury
medicine.medical_treatment
0211 other engineering and technologies
lcsh:Medicine
02 engineering and technology
Stress Disorders
Post-Traumatic

0302 clinical medicine
Injury Severity Score
Postoperative Complications
Prevalence
Medicine and Health Sciences
Young adult
lcsh:Science
Connective Tissue Diseases
Trauma Medicine
Multidisciplinary
Medical record
Post-Traumatic Stress Disorder
Osteomyelitis
Prognosis
Anxiety Disorders
Infectious Diseases
Musculoskeletal injury
medicine.symptom
Traumatic Injury
Research Article
Adult
medicine.medical_specialty
Traumatic brain injury
Neuropsychiatric Disorders
Neuroses
Amputation
Surgical

03 medical and health sciences
Young Adult
Rheumatology
Osteoarthritis
Mental Health and Psychiatry
medicine
Humans
Surgical Wound Infection
Pain Management
Veterans Affairs
021110 strategic
defence & security studies

business.industry
Arthritis
lcsh:R
Correction
030208 emergency & critical care medicine
Recovery of Function
Myalgia
medicine.disease
United States
Amputation
Musculoskeletal Injury
Physical therapy
Osteoporosis
lcsh:Q
business
Neurotrauma
Leg Injuries
Zdroj: PLoS ONE
PLoS ONE, Vol 12, Iss 1, p e0170569 (2017)
ISSN: 1932-6203
Popis: Little research has described the long-term health outcomes of patients who had combat-related amputations or leg-threatening injuries. We conducted retrospective analysis of Department of Defense and Department of Veterans Affairs health data for lower extremity combat-injured patients with (1) unilateral amputation within 90 days postinjury (early amputation, n = 440), (2) unilateral amputation more than 90 days postinjury (late amputation, n = 78), or (3) leg-threatening injuries without amputation (limb salvage, n = 107). Patient medical records were analyzed for four years postinjury. After adjusting for group differences, early amputation was generally associated with a lower or similar prevalence for adverse physical and psychological diagnoses (e.g., pain, osteoarthritis, posttraumatic stress disorder) versus late amputation and/or limb salvage. By contrast, early amputation was associated with an increased likelihood of osteoporosis during the first year postinjury. The prevalence of posttraumatic stress disorder increased for all patient groups over four years postinjury, particularly in the second year. The different clinical outcomes among combat extremity injured patients treated with early amputation, late amputation, or limb salvage highlight their different healthcare requirements. These findings can inform and optimize the specific treatment pathways that address the physical and psychological healthcare needs of such patients over time.
Databáze: OpenAIRE