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Posttraumatic Amputations Epidemiology and Outcomes Within the National Trauma Data Bank: Improved Survival Over Time
Brooke C Hergert1, Amtul-Noor Rana, Jose E Velasquez
1From the Department of Physical Medicine and Rehabilitation, Dell Medical School at The University of Texas at Austin, Austin, Texas (BCH, KAW); The University of Texas at Austin, Dell Medical School at The University of Texas at Austin, Austin, Texas (AR); The University of Texas at Austin, Steve Hicks School of Social Work, Austin, Texas (JEV); and Department of Surgery and Perioperative Care, Dell Medical School at The University of Texas at Austin, Austin, Texas (AEJ, SA, PGT).
Objective:
Acute trauma care has significantly reduced mortality over the last two decades. The last study to examine the epidemiology of traumatic amputees predates these gains. The majority of those who sustain traumatic amputation are male; therefore, limited data exist on female amputees. This study aimed to (1) provide a current epidemiological analysis of traumatic amputees and (2) compare male and female amputees.
Design:
All patients sustaining a major limb amputation in the National Trauma Data Bank from 2013 to 2017 were identified. First, descriptive analyses of patient demographics and injury characteristics were performed and compared with a previous 2000-2004 National Trauma Data Bank study. Second, female and male traumatic amputees were compared in this study.
Results:
From 2013 to 2017, we identified 7016 patients who underwent major limb amputation. Compared with previous years, the current amputees were older and more severely injured. Mortality was 6.3% in the current years compared with 13.4% in the previous years (odds ratio, 0.44, 95% CI = 0.37-0.51, P < 0.001). After multivariable analysis, mortality remained significantly decreased, with no difference in hospital length of stay.
Conclusions:
Contemporary National Trauma Data Bank analysis demonstrated that patients with traumatic amputations, regardless of sex, often survive until hospital discharge, despite more severe injuries.
