A comparison of health outcomes for combat amputee and limb salvage patients injured in Iraq and Afghanistan wars

• DOI: 10.1097/ta.0b013e318299d95e
• Publication Date: 2013-07-24T21:33:31Z
• Authors: Ted Melcer; Vernon Franklin S...; Jay Walker; Michael Galarneau
• Keywords: Medical record

BACKGROUND Treatment of military combatants who sustain leg-threatening injuries remains one the leading challenges for providers. The present study provides systematic health outcome data to inform decisions on definitive surgical treatment, namely amputation versus limb salvage, most serious leg injuries. METHODS This was a retrospective analysis records patients sustained lower-extremity in Iraq and Afghanistan conflicts, 2001 2008. Patients had (1) during first 90 days after injury (early amputees, n = 587), (2) more than (late 84), or (3) without (limb salvage [LS], 117). Injury outcomes were followed up 24 months. RESULTS After adjusting group differences, early amputees LS similar rates physical complications. Early significantly reduced psychological diagnoses (posttraumatic stress disorder, substance abuse) received outpatient care, particularly psychological, compared with patients. Late higher many mental diagnoses, including prolonged infections pain issues, CONCLUSION associated adverse relative late short term. Most evident that poorest outcomes. These findings can care providers differing clinical consequences LS. results indicate need separate pathways LEVEL OF EVIDENCE Epidemiologic prognostic study, level III.