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Ten years at war: comprehensive analysis of amputation trends
Chad A Krueger1, Joseph C Wenke, James R Ficke
1Brooke Army Medical Center, Fort Sam Houston, Texas, USA. chad.krueger@amedd.army.mil
The Journal of Trauma and Acute Care Surgery
|November 30, 2012
Summary
The number of major extremity amputations in US Service Members has increased significantly in recent years. Most amputations involve lower limbs, with a higher rate of multiple amputations compared to past conflicts.
Area of Science:
- Military Medicine
- Trauma Surgery
- Epidemiology
Background:
- Limited overarching characterization of extremity amputations in recent US military conflicts.
- Need for comprehensive data on amputation injuries sustained by US Service Members.
Purpose of the Study:
- To characterize major extremity amputations in US Service Members from 2001 to 2011.
- To analyze trends, levels, and mechanisms of amputation injuries.
Main Methods:
- Retrospective epidemiologic study of major extremity amputations.
- Data collected: amputation level, injury mechanism, time to amputation, ISS, demographics, trauma admissions, troop deployment.
- Study period: January 2001 – July 2011 (Level IV evidence).
Main Results:
- 1,221 amputees with 1,631 major extremity amputations identified.
- Significant increase in amputations in 2010 and early 2011.
- Most common amputation levels: transtibial (41.8%) and transfemoral (34.5%).
- 30% sustained multiple amputations; 14% involved upper extremities.
- 10% had amputations >90 days post-injury.
Conclusions:
- Amputation rates increased in 2010-2011 conflicts.
- Lower extremity amputations are most prevalent.
- Higher incidence of multiple amputations in current conflicts compared to previous ones.