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VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration
- 作者:Paula K Shireman (2)
Todd E Rasmussen (3) (4) Carlos A Jaramillo (5) Mary Jo Pugh (6)
2. Department of Surgery ; Sam and Ann Barshop Institute for Longevity and Aging Studies ; University of Texas Health Science Center San Antonio ; The South Texas Veterans Health Care System ; 7703 Floyd Curl Drive ; MC 7790 ; San Antonio ; TX ; 78229-3900 ; USA 3. US Combat Casualty Care Research Program ; Fort Detrick ; Frederick ; MD ; 21702-5012 ; USA 4. The Uniformed Services University ; Bethesda ; MD ; 20814 ; USA 5. Department of Rehabilitation Medicine ; University of Texas Health Science Center San Antonio ; Polytrauma Rehabilitation Center ; South Texas Veterans Healthcare System ; 7400 Merton Minter BLVD ; San Antonio ; TX ; 78229 ; USA 6. Department of Epidemiology and Biostatistics ; University of Texas Health Science Center San Antonio ; The South Texas Veterans Health Care System ; 7400 Merton Minter BLVD ; San Antonio ; TX ; 78229 ; USA
- 关键词:Extremity vascular injury ; Limb salvage ; Outcomes ; Transitions of care ; Service members ; Veterans ; Iraq ; Afghanistan
- 刊名:BMC Surgery
- 出版年:2015
- 出版时间:December 2015
- 年:2015
- 卷:15
- 期:1
- 全文大小:73 KB
- 参考文献:1. Hughes CW: The primary repair of wounds of major arteries; an analysis of experience in Korea in 1953. / Ann Surg 1955,141(3):297-03. 10.1097/00000658-195503000-00002 7/00000658-195503000-00002" target="_blank" title="It opens in new window">CrossRef
2. Rich NM, Baugh JH, Hughes CW: Acute arterial injuries in Vietnam: 1,000 cases. / J Trauma 1970,10(5):359-9. 10.1097/00005373-197005000-00001 7/00005373-197005000-00001" target="_blank" title="It opens in new window">CrossRef 3. Sayer NA, Chiros CE, Sigford B, Scott S, Clothier B, Pickett T, / et al.: Characteristics and rehabilitation outcomes among patients with blast and other injuries sustained during the Global War on Terror. / Arch Phys Med Rehabil 2008,89(1):163-0. 10.1016/j.apmr.2007.05.025 7.05.025" target="_blank" title="It opens in new window">CrossRef 4. Rasmussen TE, Clouse WD, Peck MA, Bowser AN, Eliason JL, Cox MW, / et al.: Development and implementation of endovascular capabilities in wartime. / J Trauma 2008,64(5):1169-6. discussion 1176 10.1097/TA.0b013e31816b6564 7/TA.0b013e31816b6564" target="_blank" title="It opens in new window">CrossRef 5. White JM, Stannard A, Burkhardt GE, Eastridge BJ, Blackbourne LH, Rasmussen TE: The epidemiology of vascular injury in the wars in Iraq and Afghanistan. / Ann Surg 2011,253(6):1184-. 10.1097/SLA.0b013e31820752e3 7/SLA.0b013e31820752e3" target="_blank" title="It opens in new window">CrossRef 6. Gifford SM, Aidinian G, Clouse WD, Fox CJ, Porras CA, Jones WT, / et al.: Effect of temporary shunting on extremity vascular injury: an outcome analysis from the Global War on Terror vascular injury initiative. / J Vasc Surg 2009,50(3):549-5. discussion 555-46 10.1016/j.jvs.2009.03.051 CrossRef 7. Higgins TF, Klatt JB, Beals TC: Lower Extremity Assessment Project (LEAP)–the best available evidence on limb-threatening lower extremity trauma. / Orthop Clin North Am 2010,41(2):233-. 10.1016/j.ocl.2009.12.006 CrossRef 8. Bosse MJ, MacKenzie EJ, Kellam JF, Burgess AR, Webb LX, Swiontkowski MF, / et al.: An analysis of outcomes of reconstruction or amputation after leg-threatening injuries. / N Engl J Med 2002,347(24):1924-1. 10.1056/NEJMoa012604 CrossRef 9. MacKenzie EJ, Jones AS, Bosse MJ, Castillo RC, Pollak AN, Webb LX, / et al.: Health-care costs associated with amputation or reconstruction of a limb-threatening injury. / J Bone Joint Surg Am 2007,89(8):1685-2. 10.2106/JBJS.F.01350 CrossRef 10. Patterson BM, Agel J, Swiontkowski MF, Mackenzie EJ, Bosse MJ: Knee dislocations with vascular injury: outcomes in the Lower Extremity Assessment Project (LEAP) Study. / J Trauma 2007,63(4):855-. 10.1097/TA.0b013e31806915a7 7/TA.0b013e31806915a7" target="_blank" title="It opens in new window">CrossRef 11. Doukas WC, Hayda RA, Frisch HM, Andersen RC, Mazurek MT, Ficke JR, / et al.: The Military Extremity Trauma Amputation/Limb Salvage (METALS) study: outcomes of amputation versus limb salvage following major lower-extremity trauma. / J B - 刊物主题:Surgery; Internal Medicine;
- 出版者:BioMed Central
- ISSN:1471-2482
文摘
Background Limb injuries comprise 50-60% of U.S. Service member’s casualties of wars in Afghanistan and Iraq. Combat-related vascular injuries are present in 12% of this cohort, a rate 5 times higher than in prior wars. Improvements in medical and surgical trauma care, including initial in-theatre limb salvage approaches (IILS) have resulted in improved survival and fewer amputations, however, the long-term outcomes such as morbidity, functional decline, and risk for late amputation of salvaged limbs using current process of care have not been studied. The long-term care of these injured warfighters poses a significant challenge to the Department of Defense (DoD) and Department of Veterans Affairs (VA). Methods/Design The VA Vascular Injury Study (VAVIS): VA-DoD Extremity Injury Outcomes Collaborative, funded by the VA, Health Services Research and Development Service, is a longitudinal cohort study of Veterans with vascular extremity injuries. Enrollment will begin April, 2015 and continue for 3?years. Individuals with a validated extremity vascular injury in the Department of Defense Trauma Registry will be contacted and will complete a set of validated demographic, social, behavioral, and functional status measures during interview and online/ mailed survey. Primary outcome measures will: 1) Compare injury, demographic and geospatial characteristics of patients with IILS and identify late vascular surgery related limb complications and health care utilization in Veterans receiving VA vs. non-VA care, 2) Characterize the preventive services received by individuals with vascular repair and related outcomes, and 3) Describe patient-reported functional outcomes in Veterans with traumatic vascular limb injuries. Discussion This study will provide key information about the current process of care for Active Duty Service members and Veterans with polytrauma/vascular injuries at risk for persistent morbidity and late amputation. The results of this study will be the first step for clinicians in VA and military settings to generate evidence-based treatment and care approaches to these injuries. It will identify areas where rehabilitation medicine and vascular specialty care or telehealth options are needed to allow for better planning, resource utilization, and improved DoD-to-VA care transitions.
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