@article{ref1,
title="Incidence and characterization of major upper-extremity amputations in the National Trauma Data Bank",
journal="Journal of bone and joint surgery open access",
year="2018",
author="Inkellis, Elizabeth and Low, Eric Edison and Langhammer, Christopher and Morshed, Saam",
volume="3",
number="2",
pages="e0038-e0038",
abstract="BACKGROUND: There are few recent data examining the epidemiology of severe upper-extremity trauma in non-military patients. We used the National Trauma Data Bank (NTDB) to investigate the epidemiology and descriptive characteristics of upper-extremity amputations in U.S. trauma centers. <br><br>METHODS: We queried the 2009 to 2012 NTDB research datasets for patients undergoing major upper-extremity amputation and extracted characteristics of the patient population, injury distribution, and treating facilities. In addition, multivariable regression models were fit to identify correlates of reoperation, major in-hospital complications, duration of hospitalization, and in-hospital mortality. <br><br>RESULTS: A total of 1,386 patients underwent a major upper-extremity amputation secondary to a trauma-related upper-extremity injury, representing 46 per 100,000 NTDB trauma admissions from 2009 to 2012. The most frequent definitive procedures performed were amputations through the humerus (35%), forearm (30%), and hand (14%). The average duration of hospitalization for all amputees was 17 days. Thirty-one percent of patients underwent at least 1 reoperation. The rate of reoperation was significantly higher at university-associated hospitals compared with nonteaching or community hospitals (p < 0.0001). Patients who had at least 1 reoperation stayed in the hospital approximately 7 days longer than patients who did not undergo reoperation. The Injury Severity Score, hospital teaching status, concomitant neurovascular injury, and occurrence of a complication were significantly associated with reoperation. <br><br>CONCLUSIONS: The present study provides an updated report on the epidemiology and characteristics of trauma-related major upper-extremity amputation in the U.S. civilian population. Additional work is necessary to assess the long-term outcomes following attempted upper-extremity salvage. The population-level data provided by the present study may help to inform the design and implementation of future studies on the optimum treatment for this survivable but life-altering injury.<p /> <p>Language: en</p>",
language="en",
issn="2472-7245",
doi="10.2106/JBJS.OA.17.00038",
url="http://dx.doi.org/10.2106/JBJS.OA.17.00038"
}