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OBJECTIVE To estimate the current prevalence of limb loss in the United States and project the future prevalence to the year 2050. DESIGN Estimates were constructed using age-, sex-, and race-specific incidence rates for amputation combined with age-, sex-, and race-specific assumptions about mortality. Incidence rates were derived from the 1988 to 1999(More)
ASCOT (A Severity Characterization of Trauma) is a physiologic and anatomic characterization of injury severity which combines emergency department admission values of Glasgow Coma Scale, systolic blood pressure, respiratory rate, patient age, and AIS-85 anatomic injury scores in a way that obviates ISS shortcomings. ASCOT values are related to survival(More)
BACKGROUND High-energy trauma to the lower extremity presents challenges with regard to reconstruction and rehabilitation. Failed efforts at limb salvage are associated with increased patient mortality and high hospital costs. Lower-extremity injury-severity scoring systems were developed to assist the surgical team with the initial decision to amputate or(More)
BACKGROUND Hospitals have difficulty justifying the expense of maintaining trauma centers without strong evidence of their effectiveness. To address this gap, we examined differences in mortality between level 1 trauma centers and hospitals without a trauma center (non-trauma centers). METHODS Mortality outcomes were compared among patients treated in 18(More)
BACKGROUND Plantar sensation is considered to be a critical factor in the evaluation of limb-threatening lower extremity trauma. The present study was designed to determine the long-term outcomes following the treatment of severe lower extremity injuries in patients who had had absent plantar sensation at the time of the initial presentation. METHODS We(More)
BACKGROUND The purpose of this study was to provide a comprehensive perspective on the epidemiology and time trends in the incidence of limb amputations and limb deficiency in the United States. METHODS Data from the Healthcare Cost and Utilization Project from 1988 through 1996 were used to calculate rates of congenital deficiency, trauma-related,(More)
BACKGROUND Risk-adjusted analyses are critical in evaluating trauma outcomes. The National Trauma Data Bank (NTDB) is a statistically robust registry that allows such analyses; however, analytical techniques are not yet standardized. In this study, we examined peer-reviewed manuscripts published using NTDB data, with particular attention to characteristics(More)
BACKGROUND A better understanding of the factors influencing return to work (RTW) after major limb trauma is essential in reducing the high costs associated with these injuries. METHODS Patients (n = 423) who underwent amputation or reconstruction after limb threatening lower extremity trauma and who were working before the injury were prospectively(More)
BACKGROUND Limb salvage for severe trauma has replaced amputation as the primary treatment in many trauma centers. However, long-term outcomes after limb reconstruction or amputation have not been fully evaluated. METHODS We performed a multicenter, prospective, observational study to determine the functional outcomes of 569 patients with severe leg(More)
OBJECTIVE Provide a systematic review of the published literature assessing the affect of trauma center/system implementation on patient outcomes. DATA SOURCES A bibliographic search of MEDLINE (1966-May of 1998), HealthSTAR (1995-May of 1998), and CINAHL (1982-May of 1998). Additional manuscripts were identified in the references of reviewed manuscripts.(More)