MacKenzie E J, Bosse M J, Kellam J F, Burgess A R, Webb L X, Swiontkowski M F, Sanders R W, Jones A L, McAndrew M P, Patterson T M, McCarthy M L
Johns Hopkins School of Public Health, Baltimore, Maryland 21205, USA.
J Orthop Trauma. 2000 Sep-Oct;14(7):455-66. doi: 10.1097/00005131-200009000-00001.
(a) to report the demographic, socioeconomic, behavioral, social, and vocational characteristics of patients enrolled in a study to examine outcomes after high-energy lower extremity trauma (HELET) and to compare them with the general population; (b) to determine whether characteristics of patients undergoing limb salvage versus amputation after HELET are significantly different from each other.
A prospective study of 601 patients admitted with high-energy lower extremity trauma to eight Level I trauma centers.
Patients were evaluated during the initial hospitalization. They are being followed up for 24 months postinjury. Study patients are compared with the general population by using census information, population survey data, and published norms. Characteristics of patients undergoing limb salvage versus amputation are also compared.
Most patients were male (77 percent), white (72 percent), and between the ages of twenty and forty-five years (71 percent). Seventy percent graduated from high school (compared with 86 percent nationally) (p < 0.05). One fourth lived in households with incomes below the federal poverty line, compared with 16 percent nationally (p < 0.05). The percentage with no health insurance (38 percent) was also higher than in the general population (20 percent) (p < .05). The percentage of heavy drinkers was over two times higher than reported nationally (p < 0.01). Study patients were slightly more neurotic and extroverted and less open to new experiences. When patient characteristics were compared for those undergoing amputation versus limb salvage, no significant differences were found among any of the variables (p > 0.05).
In conclusion, LEAP patients differ in important ways from the general population. However, the decision to amputate verus reconstruct does not appear to be significantly influenced by patient characteristics.
(a)报告一项研究中纳入的高能下肢创伤（HELET）患者的人口统计学、社会经济、行为、社会和职业特征，并将其与普通人群进行比较；(b)确定高能下肢创伤后接受保肢与截肢治疗的患者特征是否存在显著差异。
对8家一级创伤中心收治的601例高能下肢创伤患者进行的前瞻性研究。
在患者初次住院期间进行评估。对其伤后24个月进行随访。通过使用人口普查信息、人口调查数据和已发表的标准，将研究患者与普通人群进行比较。还比较了接受保肢与截肢治疗的患者特征。
大多数患者为男性（77%）、白人（72%），年龄在20至45岁之间（71%）。70%的患者高中毕业（全国为86%）（p<0.05）。四分之一的患者生活在收入低于联邦贫困线 的家庭中，全国这一比例为16%（p<0.05）。没有医疗保险的患者比例（38%）也高于普通人群（20%）（p<0.05）。酗酒者的比例比全国报告的高出两倍多（p<0.01）。研究患者在神经质和外向性方面略高，对新体验的开放性略低。当比较接受截肢与保肢治疗患者的特征时，未发现任何变量之间存在显著差异（p>0.05）。
总之，LEAP研究中的患者在重要方面与普通人群不同。然而，截肢与重建的决策似乎并未受到患者特征的显著影响。
