Retrospective observational study of characteristics of persons with amputations accessing International Committee of the Red Cross (ICRC) rehabilitation centres in five conflict and postconflict countries.
Retrospective observational study of characteristics of persons with amputations accessing International Committee of the Red Cross (ICRC) rehabilitation centres in five conflict and postconflict countries.
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DOI：
10.1136/bmjopen-2021-049533
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发表时间：
2021-12-01
期刊：
影响因子：
2.9
通讯作者：
O'Sullivan C
中科院分区：
文献类型：
--
作者：
Barth CA;Wladis A;Blake C;Bhandarkar P;Aebischer Perone S;O'Sullivan C
在冲突、事故和管理不善的糖尿病等脆弱环境中，截肢发生率特别高。该研究的目的是分析（1）任何类型的后天截肢（PwA）的人口统计学和截肢特征，以及（2）截肢和首次获得康复之间的时间在五个冲突和冲突后国家。一项回顾性、观察性研究，分析了创伤性和非创伤性截肢患者在人口统计学和临床因素以及康复时间方面的差异。红十字国际委员会全球数据库中PwA数量最多的五个国家（阿富汗、柬埔寨、伊拉克、缅甸、苏丹）。2009年至2018年的清理和合并数据按性别汇总;截肢和登记时的年龄;截肢的原因，组合和解剖水平;生活环境。所有PwA新参加康复。纳入了28446人的数据（4329人（15.2%）为女性）。大多数是创伤性截肢（73.4%，20 890）;其中，48.6%（13 801）与冲突有关。男性和女性创伤性截肢的平均年龄分别为26.9岁和24.1岁;非创伤性截肢的平均年龄分别为49.1岁和45.9岁。创伤性和非创伤性原因的年龄性别差异具有统计学意义（p<0.001，p=0.003）。创伤性截肢者从截肢到康复的时间平均为8.2年，显著高于非创伤性截肢者的平均3年（p<0.001）。创伤性截肢和非创伤性截肢的年龄都很小，这表明战争和脆弱的卫生系统对社会造成了毁灭性影响。截肢和康复之间的长期拖延表明了需求和资源的不匹配。对于脆弱环境中的康复服务提供者来说，管理各种原因、年龄、性别和其他条件的PwA的多样性是一项艰巨的任务。建议加强初级保健、手术和康复服务之间的合作，优先考虑康复和增加资源提供，以确保PwA充分获得全面的康复护理。
Limb amputation incidence is particularly high in fragile contexts due to conflict, accidents and poorly managed diabetes. The study aim was to analyse (1) demographic and amputation characteristics of persons with any type of acquired amputation (PwA) and (2) time between amputation and first access to rehabilitation in five conflict and postconflict countries. A retrospective, observational study analysing differences in demographic and clinical factors and time to access rehabilitation between users with traumatic and non-traumatic amputations. Five countries with the highest numbers of PwA in the global International Committee of the Red Cross database (Afghanistan, Cambodia, Iraq, Myanmar, Sudan). Cleaned and merged data from 2009 to 2018 were aggregated by sex; age at amputation and registration; cause, combination and anatomical level of amputation(s); living environment. All PwA newly attending rehabilitation. Data for 28 446 individuals were included (4 329 (15.2%) female). Most were traumatic amputations (73.4%, 20 890); of these, 48.6% (13 801) were conflict related. Average age at traumatic amputation for men and women was 26.9 and 24.1 years, respectively; for non-traumatic amputation it was 49.1 years and 45.9 years, respectively. Sex differences in age were statistically significant for traumatic and non-traumatic causes (p<0.001, p=0.003). Delay between amputation and rehabilitation was on average 8.2 years for those with traumatic amputation, significantly higher than an average 3 years for those with non-traumatic amputation (p<0.001). Young age for traumatic and non-traumatic amputations indicates the devastating impact of war and fragile health systems on a society. Long delays between amputation and rehabilitation reveal the mismatch of needs and resources. For rehabilitation service providers in fragile settings, it is an enormous task to manage the diversity of PwA of various causes, age, sex and additional conditions. Improved collaboration between primary healthcare, surgical and rehabilitation services, a prioritisation of rehabilitation and increased resource provision are recommended to ensure adequate access to comprehensive rehabilitation care for PwA.
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影响因子：
3
作者：
Aziz, Abdul Razzak Abdul;Alsabek, Mhd Belal
通讯作者：
Alsabek, Mhd Belal
DOI：
10.1080/17483107.2018.1468496
发表时间：
2018-01-01
影响因子：
2.2
作者：
MacLachlan, Malcolm;Banes, David;Hooks, Hilary
通讯作者：
Hooks, Hilary
影响因子：
3.4
作者：
Dougherty, Paul J.;McFarland, Lynne V.;Reiber, Gayle E.
通讯作者：
Reiber, Gayle E.
影响因子：
2.2
作者：
Ferguson, A;Richie, BS;Gomez, M
通讯作者：
Gomez, M
影响因子：
8
作者：
Boulton, AJM
通讯作者：
Boulton, AJM