دورية أكاديمية
A Retrospective Comparison of Five-Year Health Outcomes Following Upper Limb Amputation and Serious Upper Limb Injury in the Iraq and Afghanistan Conflicts.
| العنوان: | A Retrospective Comparison of Five-Year Health Outcomes Following Upper Limb Amputation and Serious Upper Limb Injury in the Iraq and Afghanistan Conflicts. |
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| المؤلفون: | Melcer T; Department of Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, 140 Sylvester Road, San Diego, CA 92106-3521., Walker J; Department of Medical Modeling, Simulation, and Mission Support Naval Health Research Center, Leidos, San Diego, CA., Sechriest VF 2nd; Department of Orthopedic Surgery, Minneapolis Veterans Affairs Hospital, Minneapolis VA Health Care System, Minneapolis, MN., Bhatnagar V; VA San Diego Healthcare System, San Diego, CA.; Department for Family and Preventive Medicine, University of California San Diego, La Jolla, CA., Richard E; VA San Diego Healthcare System, San Diego, CA.; Department for Family and Preventive Medicine, University of California San Diego, La Jolla, CA., Perez K; Department of Medical Modeling, Simulation, and Mission Support Naval Health Research Center, Leidos, San Diego, CA., Galarneau M; Department of Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, CA. |
| المصدر: | PM & R : the journal of injury, function, and rehabilitation [PM R] 2019 Jun; Vol. 11 (6), pp. 577-589. Date of Electronic Publication: 2019 Mar 29. |
| نوع المنشور: | Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 101491319 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1934-1563 (Electronic) Linking ISSN: 19341482 NLM ISO Abbreviation: PM R Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2019- : [Hoboken, NJ] : Wiley Original Publication: New York, NY : Elsevier |
| مواضيع طبية MeSH: | Military Personnel* , Warfare*, Amputation, Traumatic/*epidemiology , Upper Extremity/*injuries, Adult ; Afghan Campaign 2001- ; Amputation, Traumatic/psychology ; Blast Injuries/epidemiology ; Blast Injuries/psychology ; Cohort Studies ; Fractures, Ununited/epidemiology ; Humans ; Iraq War, 2003-2011 ; Male ; Mood Disorders/epidemiology ; Neck Pain/epidemiology ; Obesity/epidemiology ; Osteoarthritis/epidemiology ; Osteomyelitis/epidemiology ; Pulmonary Embolism/epidemiology ; Retrospective Studies ; Stress Disorders, Post-Traumatic/epidemiology ; United States/epidemiology ; Venous Thrombosis/epidemiology |
| مستخلص: | Background: Limited population-based research has described long-term health outcomes following combat-related upper limb amputation. Objective: To compare health outcomes following upper limb amputation with outcomes following serious upper limb injury during the first 5 years postinjury. Design: Retrospective cohort. Setting: Departments of Defense (DoD) and Veterans Affairs (VA) inpatient and outpatient health care facilities. Participants: Three-hundred eighteen U.S. Service Members. Methods: Patients sustained an above elbow (AE, n = 51) or below elbow (BE, n = 80) amputation or serious arm injury without amputation (NO AMP, n = 187) in the Iraq or Afghanistan conflicts, 2001 through 2008. Injuries were coded by trauma nurses. Outcomes came from DoD and VA health databases. Main Outcome Measurements: International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes. Results: Most patients were injured by blast weaponry causing serious to severe injuries. All groups had a high prevalence of physical and psychological health diagnoses. The prevalence for nearly all wound complications and many physical and psychological disorders decreased substantially after postinjury year 1. The prevalence of posttraumatic stress disorder, however, increased significantly from postinjury year 1 (20%) to 3 (36%). Pain and psychological disorders ranged from 69% to 90% of patients during postinjury year 1 and remained relatively high even postinjury during year 5 (37%-53%). After adjusting for covariates, the AE group had significantly higher odds for some physical and psychological diagnoses (eg, deep vein thrombosis/pulmonary embolism, cervical pain, osteoarthritis, obesity, and mood and adjustment disorders) relative to the BE or NO AMP groups. BE patients had significantly lower odds for osteomyelitis, and AE and BE patients had lower odds for fracture nonunion and joint disorders versus NO AMP. Conclusions: The results identify similarities and differences in clinical outcomes following combat-related upper limb amputation versus serious arm injury and can inform medical planning to improve rehabilitation programs and outcomes for these patients. Level of Evidence: III. (Published 2018. This article is a U.S. Government work and is in the public domain in the USA.) |
| تواريخ الأحداث: | Date Created: 20190330 Date Completed: 20200504 Latest Revision: 20200505 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1002/pmrj.12047 |
| PMID: | 30925199 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1934-1563 |
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| DOI: | 10.1002/pmrj.12047 |