Post-Traumatic Amputations Epidemiology and Outcomes Within The National Trauma Data Bank: Improved Survival Over Time Results in Increased Population in Need of Rehabilitation Support.

Abstract

Acute trauma care has significantly reduced mortality over the last two decades. The last study to examine the epidemiology of traumatic amputees predates these gains. The majority of those who sustain traumatic amputation are male; therefore, limited data exist on female amputees. This study aimed to (1) provide a current epidemiological analysis of traumatic amputees, and (2) compare male and female amputees. All patients sustaining a major limb amputation in the National Trauma Data Bank (NTDB) from 2013 to 2017 were identified. First, descriptive analyses of patient demographics and injury characteristics were performed and compared with a prior 2000-2004 NTDB study. Second, female and male traumatic amputees were compared in this study. From 2013 to 2017 we identified 7,016 patients who underwent major limb amputation. Compared to prior years, the current amputees were older and more severely injured. Mortality was 6.3% in the current years compared to 13.4% in the prior years (odds ratio [OR] 0.44, 95% CI = 0.37 to 0.51, p < 0.001). After multivariable analysis, mortality remained significantly decreased, with no difference in hospital length of stay. Contemporary NTDB analysis demonstrated that patients with traumatic amputations, regardless of sex, often survive until hospital discharge, despite more severe injuries.