African Annals of
Thoracic and Cardiovascular Surgery

OFFICIAL PUBLICATION OF THE AFRICAN ASSOCIATION OF THORACIC AND CARDIO-VASCULAR SURGEONS
  • Abbreviation: Afr. Ann. Thorac. Cardiovasc. Surg.
  • Language: English
  • ISSN: 1994-7461
  • DOI: 10.5897/AATCVS
  • Start Year: 2005
  • Published Articles: 29

Full Length Research Paper

Insurance type is a major predictor of lower extremity amputation following infra-popliteal arterial trauma

HWABEJIRE, J. O.
  • HWABEJIRE, J. O.
  • Department of Surgery, Howard University and Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
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NEMBHARD, C.
  • NEMBHARD, C.
  • Department of Surgery, Howard University and Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
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OBIRIEZE, A.C.
  • OBIRIEZE, A.C.
  • Department of Surgery, Howard University and Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
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WEONPO, Y.
  • WEONPO, Y.
  • Department of Surgery, Howard University and Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
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TRAN, D.
  • TRAN, D.
  • Department of Surgery, Howard University and Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
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ROSE, D.A
  • ROSE, D.A
  • Department of Surgery, Howard University and Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
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SURYANARAYANA, M.A.
  • SURYANARAYANA, M.A.
  • Department of Surgery, Howard University and Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
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CORNWELL III, E.E.
  • CORNWELL III, E.E.
  • Department of Surgery, Howard University and Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
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KAKRA, H.
  • KAKRA, H.
  • Department of Surgery, Howard University and Hospital, 2041 Georgia Avenue NW, Washington, DC 20060, USA
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  • Article Number - 76924C060761
  • Vol.11(1), pp. 84-89, June 2016
  •  Received: 18 January 2016
  •  Accepted: 17 May 2016
  •  Published: 20 June 2016

Abstract

Background: Following traumatic infrapopliteal arterial injury, salvageability of the leg is often attributed to injury-related variables. We investigated factors influencing amputation. Method: The United States’ National Trauma Data Bank was retrospectively examined identifying subjects aged ≥ 18 with tibial arterial injuries. Demographic, injury-related, co-morbid, and other variables were analyzed. Univariate and multivariable analyses determined predictors of lower extremity amputation. Results: 1921 subjects were included, mean age 38 years, 82% male, 65% had blunt injury, 58% white and 22% black. Insurance status: Private 24%, Self-Pay 20%, Medicare/Medicaid 17%, Other 14%, and Not-billed 1%. Average stay (days): ICU (4), hospital (15). Mortality was 2.5%. 13.6% had lower extremity amputation (10.6% below knee) and independent predictors of amputation were: male gender (OR:1.66,CI:1.11-2.34, P=0.012), Injury Severity Score (OR:1.62,CI:1.02-2.38, P<0.001), insurance status: Self-Pay (OR:1.76,CI:1.11-2.79, P=0.016), Medicare/Medicaid (OR:1.66, CI:1.03-2.67, P=0.039), Other (OR:1.61,CI:1.01-2.58, P=0.047), Notbilled (OR:1.52,CI:1.01-2.28, P=0.043). Conclusion: Insurance type is a major determinant of lower extremity amputation following traumatic infrapopliteal arterial injury.

Keywords: Lower extremity amputation, arterial trauma, insurance