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截肢者和非截肢者下肢损伤患者短期物理战斗和心理健康结果
Short-Term Physical and Mental Health Outcomes for Combat Amputee and Nonamputee Extremity Injury Patients
Recent combat amputees injured in the Afghanistan and Iraq wars have unique injuries and challenges during rehabilitation. This study evaluated amputee outcomes with those of nonamputee polytrauma and minor injury patients. Method: Combat amputees and nonamputee polytrauma and minor battle injury groups were identified retrospectively in military health databases and followed for 2 years postinjury. Polytrauma patients were selected to match amputee injury and demographic profiles. Outcomes data were diagnostic/procedure codes recorded longitudinally in the databases. Amputees had increased risk of numerous complications (e.g., infections, heterotopic ossification) and certain types of mental health disorders, and increased use of outpatient clinics compared with polytrauma patients. The odds of any mental health diagnosis and adjustment disorder doubled among amputees versus polytrauma patients. However, amputees had reduced odds of posttraumatic stress disorder by approximately one half compared with polytrauma patients, and these groups did not differ significantly in odds of mood or anxiety disorders. Both amputee and polytrauma groups showed increased rates of all mental health disorders versus minor injury patients. Recent combat amputees have substantially increased risk for numerous complications and certain psychological disorders versus nonamputee polytrauma patients. Postinjury care factors may facilitate initial psychological recovery and rehabilitation of recent combat amputees.