The epidemiology of amputation injuries in the Austrian helicopter emergency medical service: a retrospective, nationwide cohort study

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• 作者：H. F. Selig (1) (2) (9)
  P. Nagele (2) (3)
  W. G. Voelckel (4) (5)
  H. Trimmel (5) (6)
  M. H眉pfl (2)
  D. B. Lumenta (7) (8)
  L. P. Kamolz (1) (8)
  
• 关键词：Amputation injury ; Traumatic amputation ; Air rescue ; Prehospital ; Epidemiology
• 刊名：European Journal of Trauma and Emergency Surgery
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：38
• 期：6
• 页码：651-657
• 全文大小：257KB
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• 作者单位：H. F. Selig (1) (2) (9)
  P. Nagele (2) (3)
  W. G. Voelckel (4) (5)
  H. Trimmel (5) (6)
  M. H眉pfl (2)
  D. B. Lumenta (7) (8)
  L. P. Kamolz (1) (8)
  
  1. Section of Plastic, Aesthetic and Reconstructive Surgery, General Hospital Wr. Neustadt, Wr. Neustadt, Austria
  2. Department of Anaesthesiology and General Intensive Care and Pain Therapy, Medical University of Vienna, Vienna, Austria
  9. Clinic for Hand Surgery, Rh枚n-Klinikum AG, Bad Neustadt/Saale, Salzburger Leite 1, 97616, Bad Neustadt/Saale, Germany
  3. Department of Anesthesiology, Washington University School of Medicine, St. Louis, USA
  4. Department of Anaesthesiology and Critical Care Medicine, AUVA Trauma Center, Salzburg, Austria
  5. OEAMTC Christophorus Air Rescue Service, Vienna, Austria
  6. Department of Anaesthesiology, Emergency Medicine and General Intensive Care, General Hospital Wr. Neustadt, Wr. Neustadt, Austria
  7. Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria
  8. Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
  

文摘

Purpose Data on the epidemiological characteristics of traumatic amputations in prehospital emergency care, especially in the context of air rescue, are scarce. Therefore, we aimed to describe the epidemiology of total and subtotal amputation injuries encountered by the OEAMTC helicopter emergency medical service (HEMS) in Austria, based on an almost nationwide sample. Methods We retrospectively reviewed all HEMS rescue missions flown for amputation injuries in 2009. Only primary missions were analyzed. Results In total, 149 out of 16,100 (0.9聽%) primary HEMS rescue missions were for patients suffering from amputation injuries. Among these, HEMS physicians diagnosed 63.3聽% (n聽=聽94) total and 36.9聽% (n聽=聽55) subtotal amputations, with both groups showing a predominance of male victims (male:female ratios were 8:1 and 6:1, respectively).The highest rate occurred among adults between 45 and 64聽years of age (35.6聽%, n聽=聽53). The most common causes were working with a circular saw (28.9聽%, n聽=聽43) and processing wood (16.8聽%, n聽=聽25). The majority of the cases included digital amputation injuries (77.2聽%, n聽=聽115) that were mainly related to the index finger (36.2聽%, n聽=聽54). One hundred forty patients (94.0聽%) showed a total GCS of more than 12. Amputations were most prevalent in rural areas (84.6聽%, n聽=聽126) and between Thursday and Saturday (55.0聽%, n聽=聽82). The replantation rate after primary air transport was low (28聽%). Conclusions In the HEMS, amputation injuries are infrequent and mostly not life-threatening. However, HEMS crews need to maintain their focus on providing sufficient and fast primary care while facilitating rapid transport to a specialized hospital. The knowledge of the epidemiological characteristics of amputation injuries encountered in the HEMS gained in this study may be useful for educational and operational purposes.