Eskridge Susan L, McQuade Aidan, Huang Benjamin, Goldman Stephen M, Dearth Christopher L
Leidos, San Diego, CA 92121, USA.
Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Healthcare (Basel). 2025 May 16;13(10):1164. doi: 10.3390/healthcare13101164.
: This study assessed healthcare utilization in the first year after combat-related lower extremity injuries in 4275 U.S. Service members. Varying injury severity was hypothesized to correlate with different utilization patterns, with the limb salvage with secondary amputation (LS-SA) group expected to have the highest resource use. : Data on inpatient admissions and outpatient visits were analyzed across four injury groups: primary amputation (PA), LS-SA, limb salvage with no amputation (LS-NA), and non-threatened limb trauma (NTLT). The LS-SA group had the highest mean total bed days and intensive care unit (ICU) days, with over 40% requiring four or more hospitalizations. The sample averaged 208.9 outpatient visits. Physical therapy, orthopedics, and social work had the highest clinic engagement. : Initial engagement in therapy clinics was high for PA and LS-SA but decreased for LS-NA and NTLT after the first quarter, while primary care engagement was more consistent. Physical therapy had the highest mean clinic utilization. Most initial inpatient admissions were at Landstuhl Regional Medical Center. PA and LS-SA received the majority of outpatient care at three Advanced Rehabilitation Centers, while care was more distributed for LS-NA and NTLT. This study underscores the substantial healthcare burden of combat-related lower extremity injuries, with the LS-SA group exhibiting the greatest resource utilization. : The findings emphasize the need to optimize extremity trauma care across the Military Healthcare System as Service members with these injuries require significant healthcare resources, necessitating optimization of both care delivery and the military healthcare system.
本研究评估了4275名美国现役军人在与战斗相关的下肢受伤后第一年的医疗服务利用情况。研究假设不同的损伤严重程度与不同的利用模式相关，预计肢体挽救伴二次截肢（LS-SA）组的资源使用最高。
一期截肢（PA）、LS-SA、肢体挽救无截肢（LS-NA）和未受威胁肢体创伤（NTLT）。LS-SA组的平均总住院天数和重症监护病房（ICU）天数最高，超过40%的人需要住院四次或更多次。样本平均门诊就诊208.9次。物理治疗、骨科和社会工作的门诊参与度最高。
PA和LS-SA组在治疗诊所的初始参与度较高，但在第一季度后LS-NA和NTLT组的参与度下降，而初级保健的参与度更稳定。物理治疗的平均门诊利用率最高。大多数初始住院入院发生在兰施图尔地区医疗中心。PA和LS-SA在三个高级康复中心接受了大部分门诊护理，而LS-NA和NTLT的护理分布更为分散。本研究强调了与战斗相关的下肢损伤带来的巨大医疗负担，LS-SA组的资源利用率最高。
研究结果强调，由于患有这些损伤的现役军人需要大量医疗资源，因此有必要优化军事医疗系统中的肢体创伤护理，这需要优化护理服务和军事医疗系统。
