Yu Tommy C, Pyne Morgan, Higdon Brian, Rotman Robert, Mhaskar Rahul
Spinal Cord Injury Center. James A. Haley Veterans' Hospital, Tampa, Florida.
Morsani College of Medicine, University of South Florida, Tampa, Florida.
Fed Pract. 2022 Apr;39(4):168-174. doi: 10.12788/fp.0250. Epub 2022 Apr 13.
Despite limited data demonstrating altered hemodynamics in the lower extremities (LEs) among the population with spinal cord injury (SCI) and increased frequency of peripheral arterial disease (PAD), epidemiologic data are limited for amputations, a potential consequence. This study investigates the association of amputation due to vascular complications as a secondary outcome measure within the SCI population.
A retrospective cohort study was performed within a veteran population with SCI at a US Department of Veteran Affairs hospital to determine the prevalence of limb loss. We hypothesized that premorbid SCI increased the likelihood of LE amputation.
Of 1055 charts reviewed, 91 (8.7%) patients had an amputation, 70 (76.1%) had a dysvascular etiology. Transfemoral amputations were the most common level (n = 53) of amputation. Our results showed a positive correlation between the completeness of injury and the prevalence of amputation.
There is an increased frequency of amputation among the veteran population with SCI compared with that of the general US population. Amputations frequently occur at more proximal levels with motor complete injuries. Studies using a larger population and multiple centers are needed to confirm this alarming trend.
尽管仅有有限的数据表明脊髓损伤（SCI）人群下肢血流动力学改变以及外周动脉疾病（PAD）发病率增加，而截肢作为一种潜在后果，其流行病学数据却很有限。本研究将因血管并发症导致的截肢作为SCI人群的次要结局指标，调查其相关性。
在美国退伍军人事务部医院对患有SCI的退伍军人进行了一项回顾性队列研究，以确定肢体缺失的患病率。我们假设病前SCI会增加下肢截肢的可能性。
在审查的1055份病历中，91名（8.7%）患者进行了截肢，70名（76.1%）病因是血管性的。经股截肢是最常见的截肢部位（n = 53）。我们的结果显示损伤的完整性与截肢患病率之间呈正相关。
与美国普通人群相比，患有SCI的退伍军人截肢频率更高。截肢常发生在运动完全损伤的更近端部位。需要开展使用更大样本量和多中心的研究来证实这一惊人趋势。
