Characteristics of United States Emergency Department Visits for Traumatic Amputations in the Elderly Adult from 2010 to 2013

Bandzar, Sean; Gupta, Shabnam; Atallah, Hany; Pitts, Stephen R.

doi:10.1111/jgs.13889

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…Traumatic amputations were most common in the fingers, which is consistent with previous studies (12,26). Fingers are most vulnerable to violent injury from mechanical tools such as saws and lawnmowers, and the lack of large muscle protection on the surface leads to increased chances of amputation (27,28).…”

Section: Discussionsupporting

confidence: 88%

“…In developed countries, the burden of traumatic amputation in the older adults is not negligible due to the aging of the population. In the United States, approximately 12% of emergency department visits for older adults patients suffered traumatic amputation (12). Traumatic amputation often requires long periods of rehabilitation, severely affecting the life quality of patients, while placing a heavy burden on health systems (13,14).…”

Section: Introductionmentioning

confidence: 99%

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The global burden of traumatic amputation in 204 countries and territories

Yuan,

Hu,

et al. 2023

Front. Public Health

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BackgroundTraumatic amputation leads to disability and imposes a heavy health burden. This study aims to explore the current status and temporal trends of the global burden of traumatic amputation according to sex, age, amputation site, cause, and reginal level of social development.MethodsThe data were extracted from the Global Burden of Diseases (GBD) Study 2019. Prevalence, incidence, years lived with disability (YLDs) and corresponding age-standardized rate were compared. Estimated annual percentage change (EAPC) was applied to reflect trends in age-standardized rates over a specific period. Spearman rank test and curve fitting methods were used to analyze the relationship between disease burden and Socio-Demographic Index (SDI).ResultsGlobally, the incidence and prevalence number of traumatic amputation increased from 11.37 million and 370.25 million in 1990, to 13.23 million and 552.45 million in 2019, with a raise of 16.4 and 49.2%, respectively. But the age-standardized incidence rate (ASIR) (EAPC = −0.56; 95%CI, −0.72 to −0.41) and age-standardize prevalence rate (ASPR) (EAPC = −0.63; 95%CI, −0.74 to −0.52) declined during this period. The YLDs count also increased by 39.2% globally (from 5.28 million to 7.35 million), while the age-standardize YLDs rate (ASYR) decreased by an average of 1.00% per year (95% CI, −1.10 to −0.90) from 1990 to 2019. The incidence, prevalence, and YLDs rate of traumatic amputation continue to increase with age. Traumatic amputations were most common in the fingers, while unilateral lower limb amputation caused the greatest burden of disability. ASIR and SDI were positively correlated (ρ = 0.442, p < 0.001), while ASYR and SDI were not significantly correlated (ρ = −0.030, p = 0.669), and EAPC in ASYR and SDI were negatively correlated (ρ = −0.275, p < 0.001). Exposure to mechanical forces and falls were the leading causes of traumatic amputation.ConclusionDespite the declining trends in ASIR, ASPR, and ASYR, the incidence, prevalence, and YLDs counts of traumatic amputation have increased significantly worldwide, especially in the older adults population. With the population aging, targeted health policies are needed to address the increasing global burden of traumatic amputations in the future.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

The global burden of traumatic amputation in 204 countries and territories

Yuan,

Hu,

et al. 2023

Front. Public Health

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“…As a result, variables integral to the prognosis of each age group in the geriatric trauma population require unique consideration and exploration. [12] Mortality in the centenarian and nonagenarian population posttrauma has been shown to be associated with age in addition to mean ISS score and number of comorbidities. [13] Our findings regarding the nonagenarian population exclusively confirm these predictors of mortality.…”

Section: Discussionmentioning

confidence: 99%

A novel risk score to predict post-trauma mortality in nonagenarians

Kopatsis

Chetram

Kopatsis

et al. 2019

J Emerg Trauma Shock

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Background:Nonagenarians represent a rapidly growing age group who often have functional limitations and multiple comorbidities, predisposing them to trauma.Aims:The purpose of this study was to identify patient characteristics, hospital complications, and comorbidities that predict in-hospital mortality in the nonagenarian population following trauma. We also sought to create a scoring system using these variables.Settings and Design:This study was a retrospective chart review.Methods:We reviewed the medical records of 548 nonagenarian trauma patients admitted to two Level I trauma centers from 2006 to 2015. Statistical analysis was performed using logistic regression and a machine learning model, which calculated significant variables and computed a scoring system.Results:The in-hospital mortality rate was 7.1% (n = 39). Significant predictors of mortality were cardiac comorbidity, neuro-concussion, New Injury Severity Score (ISS) 16+, striking an object, ISS 25–75, and pulmonary and cardiac complications. Significant variables were assigned a numeric value. A score of 5+ carried a 41.1% mortality risk, 79% sensitivity, and 91% specificity. A score of 10+ had an associated 81.8% mortality risk with 31% specificity and 99% sensitivity.Conclusions:Our findings identified reliable predictors of mortality in nonagenarian population posttrauma. The scoring system performs with good specificity and sensitivity and incrementally correlates with mortality risk.

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