Genitourinary injuries and extremity amputation in Operations Enduring Freedom and Iraqi Freedom: Early findings from the Trauma Outcomes and Urogenital Health (TOUGH) project
| Autor: | Jessica C. Rivera, Jean A. Orman, Eluned A. Lewis, Douglas W. Soderdahl, Nina S. Nnamani, Judson Janak, Steven J. Hudak |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Poison control Urogenital System Critical Care and Intensive Care Medicine Amputation Surgical 03 medical and health sciences Young Adult 0302 clinical medicine Injury prevention Scrotum Epidemiology medicine Humans 030212 general & internal medicine Iraq War 2003-2011 Abbreviated Injury Scale Afghan Campaign 2001 Genitourinary system business.industry Multiple Trauma General surgery 030208 emergency & critical care medicine Extremities United States Surgery medicine.anatomical_structure Military Personnel Amputation Diagnosis code business |
| Zdroj: | The journal of trauma and acute care surgery. 81(5 Suppl 2 Proceedings of the 2015 Military Health System Research) |
| ISSN: | 2163-0763 |
| Popis: | In Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), genitourinary (GU) wounds have occurred in unprecedented numbers. Severe concomitant injuries, including extremity amputations, are common. The epidemiology of GU injury and extremity amputation in OEF/OIF has not been described.The Department of Defense Trauma Registry was queried from October 2001 through August 2013 to identify all surviving US male service members with GU injuries sustained in OEF/OIF. Genitourinary injury was defined as sustaining one or more injuries to any organ or structure within the genitourinary and/or reproductive system(s) based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Injury severity was quantified based on Abbreviated Injury Scale scores and overall Injury Severity Scores. The incidence, nature, and severity of GU injuries and extremity amputations are described.Of the 1,367 service members with GU injury included in this analysis, 433 (31.7%) had one or more extremity amputations. Most GU injuries were to the external genitalia [scrotum (55.6%), testes (33.0%), penis (31.0%), and urethra (9.1%)] vs. the kidneys (21.1%). Those with amputation(s) had greater GU injury severity (Abbreviated Injury Scale score ≥ 3) than those without amputations (50.1% vs. 30.5%, respectively; p0.0001). Approximately 3.4% of male service members with GU injury had an upper extremity amputation only, 8.9% had both lower and upper extremity amputation(s), and 19.4% had lower extremity amputation(s) only. Of the 387 patients with GU injury and lower extremity amputations, 87 (22.5%) had amputations below the knee and 300 (77.5%) had amputation(s) at/above the knee.In OEF/OIF, concomitant GU injury and extremity amputation are common and have serious implications for health and quality of life. This wounding pattern presents new challenges to the military medical and research and development communities to prevent, mitigate, and treat these battlefield injuries.Epidemiologic/prognostic study, level III. |
| Databáze: | OpenAIRE |
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