A Retrospective Comparison of Five-Year Health Outcomes Following Upper Limb Amputation and Serious Upper Limb Injury in the Iraq and Afghanistan Conflicts
Journal Article - Open Access,01 Oct 2014,30 May 2017
NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA SAN DIEGO United States
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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 year1 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 thrombosispulmonary 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. 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.
- Medicine and Medical Research