{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:42:52Z","timestamp":1790282572852,"version":"4.1.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T00:00:00Z","timestamp":1719014400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hand (New York, N,Y.)"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The loss of an upper extremity is a severely disabling condition made medically challenging by the limited window for replantation. This study aims to investigate the burden of traumatic major upper extremity amputations in the United States and uncover possibilities for improvements in treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The Healthcare Cost and Utilization Project\u2019s National Inpatient Sample was screened for International Classification of Diseases-9\/10 diagnosis\/procedure codes for traumatic and nontraumatic major upper extremity amputations and replantations within the years 2008 to 2017. The resulting pool of cases was analyzed for multiple variables, including level of injury, patient demographics, hospital type and location, length of stay, costs, comorbidities, and complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 15\u2009155 major upper extremity amputations were recorded, of which 15.20% (n = 2305) were traumatic amputations\u2014almost half of them related to the upper arm (49.6%;\n                      <jats:italic>P<\/jats:italic>\n                      = .0002). The great majority of replantations, however, was conducted at the lower arm level (87.4%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001), with an overall replantation rate of 22.3%. Nontraumatic amputations were overall associated with significantly higher burden of comorbidities relative to traumatic amputations except for long-term alcohol use (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .0001). Both, amputations and replantations, were predominantly treated in large urban teaching hospitals, and were significantly more likely to occur in white men. The Southern region of the United States was handling the highest proportion of amputations in the United States, but had the lowest likelihood of replantation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study provides an overview of the national trends in major traumatic upper extremity amputations and replantations, revealing potential health care shortcomings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15589447241259189","type":"journal-article","created":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T06:57:01Z","timestamp":1719039421000},"page":"1071-1081","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Nationwide Analysis on Major Upper Extremity Amputations and Replantations"],"prefix":"10.1177","volume":"20","author":[{"given":"Viola A.","family":"St\u00f6gner","sequence":"first","affiliation":[{"name":"Yale School of Medicine, New Haven, CT, USA"},{"name":"Hannover Medical School, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6666-8578","authenticated-orcid":false,"given":"Sacha C.","family":"Hauc","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helia","family":"Hosseini","sequence":"additional","affiliation":[{"name":"Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mica C. 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