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Prevalence of psychiatric disease after isolated traumatic upper extremity amputation
Shirley Shue, Yuewei Wu-Fienberg, Kyle J. Chepla
University Hospitals Cleveland Medical Center
2018-02-08
Presenter: Shirley Shue
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting. The program director is responsible for making a statement within the confines of the box below specific to how much of the work on this project represents the original work of the resident. All authors/submitters of each abstract should discuss this with their respective program director for accurate submission of information as well as the program director's approval for inclusion of his/her electronic signature.
Director Name: Anand Kumar
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
BACKGROUND: Psychiatric disease after traumatic limb loss impacts rehabilitation, prosthesis use, and quality of life. The purpose of this study was to evaluate the prevalence of psychiatric disease in civilians after isolated, traumatic upper extremity amputation and determine if any risk factors are associated with developing psychiatric disease.
METHODS: Demographics, time since injury, mechanism of injury, amputation level, hand affected (dominant vs non-dominant), Bureau of Workers' Compensation status, and prosthesis use were retrospectively reviewed for all patients treated from 2012-2017. For patients with an ICD-10 diagnosed psychiatric disease, the diagnosis and length of treatment was recorded. Patients were grouped by presence or absence of psychiatric diagnosis and data analysis was performed using descriptive statistics, Fisher's Exact test, and relative risk.
RESULTS: Forty-six patients met the inclusion criteria. Thirty-one patients (67.4%) had at least one diagnosed psychiatric condition. Major depressive disorder was the most common (n=14), followed by post-traumatic stress disorder (n=11), adjustment disorder (n=11), anxiety (n=6), and panic disorder (n=2). No statistically significant correlation was seen between gender, age at the time of injury, times since injury, current employment status, BWC status, hand injured (dominant vs non-dominant), prosthetic use, or level of amputation.
CONCLUSIONS: Prevalence of depression and anxiety after traumatic upper limb loss in the civilian population is similar to reported rates after combat injury. While, we were unable to identify a statistically significant association with any of the studied variables, upper extremity surgeons should be aware of the high prevalence of psychiatric disease after traumatic upper extremity amputation.
