Postinjury Care and Complications Among U.S. Military Women With Combat-Related Major Limb Traumatic Amputation.

Abstract

U.S. servicewomen may be at greater risk of injury in future conflicts as they integrate into combat occupations. More than 1,000 servicewomen were wounded during military conflicts in Iraq and Afghanistan. Some women sustained traumatic amputations, and research on their postinjury health is needed. To describe acute care, complications, and health care utilization among servicewomen with combat-related amputations, comparing them with injured men. In this retrospective matched-pairs study, women were identified from the Expeditionary Medical Encounter Database between 2003 and 2012 and matched with men on amputation injuries, injury severity, and age. Differences were assessed with nonparametric tests for paired data. Of 20 women identified for analysis, 13 received tourniquets, three were administered procoagulants, and six had massive transfusions. Women averaged 3.4 (SD = 1.6) postinjury complications, and the most frequent were heterotopic ossification (n = 17), posthemorrhagic anemias (n = 13), and bacterial wound infections (n = 10). Acute care and complications were similar among men. Women averaged more acute care days (M = 49.8, SD = 30.6) than men (M = 46.1, SD = 27.4) but fewer intensive care unit days (women: M = 2.6, SD = 4.0; men: M = 4.4, SD = 8.3). No statistical differences were observed. Postinjury care among servicewomen with combat-related amputations was comparable with servicemen, and complications were common. This information can aid providers and nursing staff in the management of these injuries.