Krueger Chad A, Wenke Joseph C
San Antonio Military Medical Center, Fort Sam Houston, TX, USA.
United States Army Institute of Surgical Research, Fort Sam Houston, TX, USA.
Injury. 2014 Aug;45(8):1231-5. doi: 10.1016/j.injury.2014.02.008. Epub 2014 Feb 15.
While many recent publications have examined the ability of amputees to return to active duty, it remains largely unknown why few amputees deploy after amputation and many amputees do not. The purpose of this study is to examine what predictor(s) exist for whether or not an amputee will deploy after sustaining a combat-related amputation.
All U.S. Service members who sustained major extremity amputations from September 2001 through July 2011 were analysed. Amputation level(s), mechanism of injury, time interval to amputation, age, rank, Physical Evaluation Board (PEB) disposition and ability to deploy after amputation were determined.
Deployment information after amputation was obtained for 953 amputees. There were 47 (5%) amputees who deployed. There were no significant differences amongst service branches for the deployment of amputees (p > 0.2). Amputees who underwent their amputation on the same day of their injury were significantly less likely to deploy after amputation than those who had their amputation on the day of injury (p = .01). Deployed amputees had significantly lower Injury Severity Scores than amputees who did not deploy (15.98 vs 20.87, p < 0.01) and officers were significantly (p < .01) more likely to deploy and the average age of amputees who deployed was significantly higher than those who did not (27.5 vs 25.1, p < .01). Lastly, those amputees who sustained a transtibial amputation were significantly more likely to deploy than all other amputation levels (p < .01). Nine out of 19 (47%) Special Forces amputees were able to deploy.
The vast majority of amputees do not able to deploy after undergoing amputation. The main predictors of deploying after sustaining a combat-related amputation appear to be: sustaining a transtibial amputation, being of senior rank or age and being a member of the Special Forces. Many of these factors appear to be non-treatment related and highlight the importance that individual and social factors play in the recovery of severe injuries.
尽管近期有许多出版物研究了截肢者重返现役的能力，但截肢后很少有截肢者被部署且许多截肢者未被部署的原因在很大程度上仍不为人知。本研究的目的是探讨在遭受与战斗相关的截肢后，存在哪些因素可预测截肢者是否会被部署。
对2001年9月至2011年7月期间遭受主要肢体截肢的所有美国军人进行了分析。确定了截肢水平、损伤机制、截肢时间间隔、年龄、军衔、体格评估委员会（PEB）处置情况以及截肢后被部署的能力。
获取了953名截肢者截肢后的部署信息。有47名（5%）截肢者被部署。各军种在截肢者部署方面无显著差异（p>0.2）。在受伤当天接受截肢的截肢者截肢后被部署的可能性明显低于在受伤当日接受截肢的截肢者（p = 0.01）。被部署的截肢者的损伤严重程度评分明显低于未被部署的截肢者（15.98对20.87，p<0.01），军官被部署的可能性明显更高（p<0.01），且被部署的截肢者的平均年龄明显高于未被部署的截肢者（27.5对25.1，p<0.01）。最后，那些遭受胫骨截肢的截肢者比所有其他截肢水平的截肢者被部署的可能性明显更高（p<0.01）。19名特种部队截肢者中有9名（47%）能够被部署。
绝大多数截肢者在截肢后无法被部署。遭受与战斗相关的截肢后被部署的主要预测因素似乎是：遭受胫骨截肢、军衔较高或年龄较大以及是特种部队成员。这些因素中的许多似乎与治疗无关，并突出了个人和社会因素在重伤恢复中所起的重要作用。
