Traumatic Amputations - A Nationwide Epidemiological Analysis of a developing country over 16 years

Abstract

ABSTRACTBackgroundDefining the impact of amputation is essential for developing cost-effective preventive health policies. Trauma is one of the most common causes of limb loss, affecting mainly the young working population. To date, few studies have investigated the epidemiology of patients undergoing trauma-related amputations and their public health implications in developing countries. The aim of this study was to analyze all limb amputations due to traumatic injuries performed in the Brazilian public health system over a 16-year period, studying their incidence, demographics, hospitalization and costs.ObjectiveTo analyze the epidemiologic data on traumatic amputations within Brazil’s public health system.MethodsThis study was a cross-sectional and retrospective population-based analysis of traumatic amputations performed in the Brazilian public health system from 2008 to 2023. DATASUS, a public database of the Brazilian public health system, was used to select trauma cases, which were filtered by the traumatic amputation code. The dataset included the number of procedures, regional distribution, patient demographics, length of hospital stay, ICU stay, lethality and financial reimbursement.ResultsThere were 202,940 traumatic amputations in Brazil between 2008 and 2023. This condition was most common in males (78.7%), with an average age of 44.77 years, mainly involving fingers (62.7%). Cases involving lower limbs led to longer hospital stays and more ICU admissions. The mean length of hospital stay was 4.57 days, culminating in a lethality of 3.15%, which remained stable during the follow-up period. The estimated total cost to the Brazilian public health system was US$ 54,870,097.79, equivalent to approximately US$ 34,29381 spent per year on traumatic amputations, with the lower limb representing twice as much per patient.ConclusionTraumatic amputation is still common in all regions of Brazil and has remained stable over the past 16 years, as has its lethality. Lesions leading to lower limb amputation account for the majority of hospital stays, intensive care unit admissions, and higher lethality and costs.