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. 2023 Oct 31;12(21):6879.
doi: 10.3390/jcm12216879.

Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage

Stephen M Goldman  1   2 , Susan L Eskridge  3 , Sarah R Franco  1   2 , Christopher L Dearth  1   2
Affiliations

Demographics and Comorbidities of United States Service Members with Combat-Related Lower Extremity Limb Salvage

Stephen M Goldman et al. J Clin Med. .

Abstract

Introduction: This retrospective study describes the demographics and injury characteristics of a recently identified cohort of US Service members with combat-related lower extremity limb salvage (LS).

Methods: US Service members with combat trauma were identified from the Expeditionary Medical Encounter Database and Military Health System Data Repository and stratified into primary amputation (PA), LS, and non-threatened limb trauma (NTLT) cohorts based on ICD-9 codes. Disparities in demographic factors and injury characteristics were investigated across cohorts and within the LS cohort based on limb retention outcome.

Results: Cohort demographics varied by age but not by sex, branch, or rank. The mechanism of injury and injury characteristics were found to be different between the cohorts, with the LS cohort exhibiting more blast injuries and greater injury burden than their peers with NTLT. A sub-analysis of the LS population revealed more blast injuries and fewer gunshot wounds in those that underwent secondary amputation. Neither demographic factors nor total injury burden varied with limb retention outcome, despite slight disparities in AIS distribution within the LS cohort.

Conclusions: In accordance with historic dogma, the LS population presents high injury severity. Demographics and injury characteristics are largely invariant with respect to limb retention outcomes, despite secondary amputation being moderately more prevalent in LS patients with blast-induced injuries. Further study of this population is necessary to better understand the factors that impact the outcomes of LS in the Military Health System.

Keywords: abbreviated injury scale; amputation; military medicine; musculoskeletal system; trauma; wound and injuries.

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Conflict of interest statement

The opinions or assertions contained herein are the private ones of the author/speaker and are not to be construed as official or reflecting the views of the Department of Defense, the Uniformed Services University of the Health Sciences or any other agency of the U.S. Government. The authors have no conflict of interest to declare.

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