NEW ORLEANS — The likelihood of complications and reoperation is very high following trauma-related amputation, according to research presented at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium.
Saam Morshed, MD, MPH, conducted a study to explore the epidemiology of upper extremity amputation using secondary data analysis from the 2009-2012 National Trauma databank.
The data included 1,386 patients from 900 trauma centers around the United States, who underwent major upper extremity amputation following trauma. Researchers used multivariate regression models to identify predictors of adverse surgical complications, rate of reoperation and length of hospitalization.
Overall, 18% of the patients studied had surgical complications post-amputation and nearly 30% of patients underwent reoperation. Compartment syndrome and neurovascular disease were the major factors for reoperation. Pneumonia was also a major factor, as 5.52% of patients had pneumonia-related complications. About 3% of patients experienced complications due to acute kidney injury and 2.86% of patients had acute lung injury or respiratory distress syndrome-related complications.
Thrombophlebitis, severe sepsis, infection and ulceration were among the other predictors of surgical complications, as well as osteomyelitis, pulmonary embolism, graft, prosthesis and flap failure.
“Extremity trauma is becoming increasingly frequent and important,” Morshed said. “Given our most recent decade of war, more than half of wounded services members evacuated from the Middle East have extremity injuries.”
This research provides a baseline for further work, he said. Future initiatives include exploring hospital teaching status, geographic region and association with outcomes. – by Shawn M. Carter
Morshed. Paper F5. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium; Feb. 18-21, 2015; New Orleans.
Disclosure: The work was funded by the Orthopedic Research and Education Foundation.