Incidence of Nerve Injury After Extremity Trauma in the United States
| Autor: | William M Padovano, Jana Dengler, Amy M. Moore, Andrew Yee, Alison K. Snyder-Warwick, Matthew D. Wood, Susan E. Mackinnon, Megan M. Patterson |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Specialty 030230 surgery Upper Extremity 03 medical and health sciences 0302 clinical medicine Quality of life Administrative database Peripheral nerve Epidemiology medicine Humans Orthopedics and Sports Medicine Retrospective Studies Surgery Articles Arm Injuries business.industry Incidence (epidemiology) Incidence Chronic pain Nerve injury medicine.disease United States Emergency medicine Quality of Life Surgery medicine.symptom Chronic Pain business 030217 neurology & neurosurgery |
| Zdroj: | Hand (N Y) |
| Popis: | Background Traumatic peripheral nerve injuries cause chronic pain, disability, and long-term reductions in quality of life. However, their incidence after extremity trauma remains poorly understood. Methods The IBM® MarketScan® Commercial Database from 2010 to 2015 was used to identify patients aged 18 to 64 who presented to emergency departments for upper and/or lower extremity traumas. Cumulative incidences were calculated for nerve injuries diagnosed within 2 years of trauma. Cox regression models were developed to evaluate the associations between upper extremity nerve injury and chronic pain, disability, and use of physical therapy or occupational therapy. Results The final cohort consisted of 1 230 362 patients with employer-sponsored health plans. Nerve injuries were diagnosed in 2.6% of upper extremity trauma patients and 1.2% of lower extremity trauma patients. Only 9% and 38% of nerve injuries were diagnosed by the time of emergency department and hospital discharge, respectively. Patients with nerve injuries were more likely to be diagnosed with chronic pain (hazard ratio [HR]: 5.9, 95% confidence interval [CI], 4.3-8.2), use physical therapy services (HR: 10.7, 95% CI, 8.8-13.1), and use occupational therapy services (HR: 19.2, 95% CI, 15.4-24.0) more than 90 days after injury. Conclusions The incidence of nerve injury in this national cohort was higher than previously reported. A minority of injuries were diagnosed by emergency department or hospital discharge. These findings may improve practitioner awareness and inform public health interventions for injury prevention. |
| Databáze: | OpenAIRE |
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