Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage
Introduction: This retrospective study describes the demographics and injury characteristics of a recently identified cohort of US Service members with combat-related lower extremity limb salvage (LS). Methods: US Service members with combat trauma were identified from the Expeditionary Medical Enco...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-10-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/21/6879 |
| _version_ | 1797631710185127936 |
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| author | Stephen M. Goldman Susan L. Eskridge Sarah R. Franco Christopher L. Dearth |
| author_facet | Stephen M. Goldman Susan L. Eskridge Sarah R. Franco Christopher L. Dearth |
| author_sort | Stephen M. Goldman |
| collection | DOAJ |
| description | Introduction: This retrospective study describes the demographics and injury characteristics of a recently identified cohort of US Service members with combat-related lower extremity limb salvage (LS). Methods: US Service members with combat trauma were identified from the Expeditionary Medical Encounter Database and Military Health System Data Repository and stratified into primary amputation (PA), LS, and non-threatened limb trauma (NTLT) cohorts based on ICD-9 codes. Disparities in demographic factors and injury characteristics were investigated across cohorts and within the LS cohort based on limb retention outcome. Results: Cohort demographics varied by age but not by sex, branch, or rank. The mechanism of injury and injury characteristics were found to be different between the cohorts, with the LS cohort exhibiting more blast injuries and greater injury burden than their peers with NTLT. A sub-analysis of the LS population revealed more blast injuries and fewer gunshot wounds in those that underwent secondary amputation. Neither demographic factors nor total injury burden varied with limb retention outcome, despite slight disparities in AIS distribution within the LS cohort. Conclusions: In accordance with historic dogma, the LS population presents high injury severity. Demographics and injury characteristics are largely invariant with respect to limb retention outcomes, despite secondary amputation being moderately more prevalent in LS patients with blast-induced injuries. Further study of this population is necessary to better understand the factors that impact the outcomes of LS in the Military Health System. |
| first_indexed | 2024-03-11T11:26:06Z |
| format | Article |
| id | doaj.art-3b9e0e1e90d645d0b59e98ce52bde6e2 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T11:26:06Z |
| publishDate | 2023-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-3b9e0e1e90d645d0b59e98ce52bde6e22023-11-10T15:06:47ZengMDPI AGJournal of Clinical Medicine2077-03832023-10-011221687910.3390/jcm12216879Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb SalvageStephen M. Goldman0Susan L. Eskridge1Sarah R. Franco2Christopher L. Dearth3Research & Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, 8901 Wisconsin Ave., Bethesda, MD 20889, USALeidos, Reston, VA 20190, USAResearch & Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, 8901 Wisconsin Ave., Bethesda, MD 20889, USAResearch & Surveillance Division, DoD-VA Extremity Trauma and Amputation Center of Excellence, 8901 Wisconsin Ave., Bethesda, MD 20889, USAIntroduction: This retrospective study describes the demographics and injury characteristics of a recently identified cohort of US Service members with combat-related lower extremity limb salvage (LS). Methods: US Service members with combat trauma were identified from the Expeditionary Medical Encounter Database and Military Health System Data Repository and stratified into primary amputation (PA), LS, and non-threatened limb trauma (NTLT) cohorts based on ICD-9 codes. Disparities in demographic factors and injury characteristics were investigated across cohorts and within the LS cohort based on limb retention outcome. Results: Cohort demographics varied by age but not by sex, branch, or rank. The mechanism of injury and injury characteristics were found to be different between the cohorts, with the LS cohort exhibiting more blast injuries and greater injury burden than their peers with NTLT. A sub-analysis of the LS population revealed more blast injuries and fewer gunshot wounds in those that underwent secondary amputation. Neither demographic factors nor total injury burden varied with limb retention outcome, despite slight disparities in AIS distribution within the LS cohort. Conclusions: In accordance with historic dogma, the LS population presents high injury severity. Demographics and injury characteristics are largely invariant with respect to limb retention outcomes, despite secondary amputation being moderately more prevalent in LS patients with blast-induced injuries. Further study of this population is necessary to better understand the factors that impact the outcomes of LS in the Military Health System.https://www.mdpi.com/2077-0383/12/21/6879traumaabbreviated injury scalemilitary medicinewound and injuriesamputationmusculoskeletal system |
| spellingShingle | Stephen M. Goldman Susan L. Eskridge Sarah R. Franco Christopher L. Dearth Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage Journal of Clinical Medicine trauma abbreviated injury scale military medicine wound and injuries amputation musculoskeletal system |
| title | Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage |
| title_full | Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage |
| title_fullStr | Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage |
| title_full_unstemmed | Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage |
| title_short | Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage |
| title_sort | demographics and comorbidities of united states service members with combat related lower extremity limb salvage |
| topic | trauma abbreviated injury scale military medicine wound and injuries amputation musculoskeletal system |
| url | https://www.mdpi.com/2077-0383/12/21/6879 |
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