{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T03:55:32Z","timestamp":1778385332639,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institute on Minorities and Health Disparities","award":["1R01MD018773-01"],"award-info":[{"award-number":["1R01MD018773-01"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vascular"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>While concomitant vascular injury is associated with an increased risk of amputation following lower extremity trauma, risk factors for amputation after attempted revascularization are lesser known. In centers where dedicated vascular traumatic expertise is not available, a lack of guidance regarding high-risk vascular trauma may limit efforts to appropriately triage and transfer patients to a higher level of care. We identified factors associated with in-hospital amputation after revascularization for isolated lower extremity trauma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The American College of Surgeons Trauma Quality Improvement Program (ACS TQIP) is a multicenter, prospectively maintained database containing deidentified traumatic admissions data for over 900 trauma centers in the United States. From 2017 to 2021, ACS TQIP was queried for adult patients undergoing arterial revascularization following isolated lower extremity trauma. Injury-related variables were derived from structured data fields, Injury Severity Scores, and Abbreviated Injury Scores. The primary endpoint was post-revascularization in-hospital lower extremity amputation. Univariate and multivariate logistic regression of demographic data, medical history, and injury-related variables were performed to identify factors associated with post-revascularization amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 5669 patients undergoing revascularization, 10.2% underwent amputation a median 8.31 days after their surgical procedure. Most revascularizations were done via open surgical approach (81.9%), followed by endovascular (13.8%) and hybrid (4.3%) methods. Amputated patients were older (39.5 vs 35.6 years,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001, Table 1) and more likely to have a preoperative history of peripheral arterial disease (1.4% vs 0.6%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.017). On multivariate logistic regression, blunt mechanism (OR 4.80,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001, Table 2), popliteal arterial injury (OR 2.11,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and concurrent bony injury (OR 2.03,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) were independently associated with amputation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the multicenter American College of Surgeons Trauma Quality Improvement Program, the overall rate of post-revascularization amputation in patients with isolated lower extremity trauma was 10.20%. Amputation risk was higher in patients with advanced age and comorbidity, suggesting that triage for revascularization already incorporates an evaluation of patient frailty. In multivariate analysis, blunt mechanism of injury, popliteal artery injury, and bony injury were independently associated with amputation. Each additional hour between admission and revascularization was associated with greater amputation risk, highlighting the importance of efforts to expediently and appropriately triage patients at with high-risk injuries to optimize limb salvage outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17085381251360074","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T05:40:14Z","timestamp":1751953214000},"page":"491-496","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Factors associated with in-hospital amputation after revascularization for lower extremity trauma"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5570-0536","authenticated-orcid":false,"given":"Vy Thuy","family":"Ho","sequence":"first","affiliation":[{"name":"Kaiser Permanente Northern California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shernaz Sophia","family":"Dossabhoy","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lakshika","family":"Tennakoon","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason Tin Aye","family":"Lee","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa Marie","family":"Knowlton","sequence":"additional","affiliation":[{"name":"Stanford University School of Medicine"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BCO.0000000000001125"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.11.005"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2011.07.005"},{"issue":"1","key":"e_1_3_5_5_2","first-page":"75","article-title":"Factors affecting outcome after traumatic limb amputation","volume":"99","author":"Perkins ZB","year":"2012","unstructured":"Perkins ZB, De\u2019Ath HD, Sharp G, et al. Factors affecting outcome after traumatic limb amputation. Br J Surg 2012; 99(1): 75\u201386.","journal-title":"Br J Surg"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481007601120"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200204000-00005"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2019.09.030"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002185"},{"key":"e_1_3_5_10_2","first-page":"441","article-title":"The American College of Surgeons trauma quality improvement Program","volume":"92","author":"Nathens AB","year":"2012","unstructured":"Nathens AB, Cryer HG, Fildes J. The American College of Surgeons trauma quality improvement Program. Surgical Clinics 2012; 92: 441\u2013454.","journal-title":"Surgical Clinics"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9689"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.04.052"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2021.12.004"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.01.052"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.27746"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.143.10.945"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-015-1126-0"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002936"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200600001-00044"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2018.03.043"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/journalofethics.2015.17.6.stas1-1506"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/1538574411415125"},{"key":"e_1_3_5_23_2","first-page":"804.e3","article-title":"Popliteal scoring assessment for vascular extremity injuries in trauma study","volume":"74","author":"O\u2019Banion LA","year":"2021","unstructured":"O\u2019Banion LA, Dirks R, Farooqui E, et al. Popliteal scoring assessment for vascular extremity injuries in trauma study. J Vasc Surg 2021; 74: 804.e3\u2013813.e3.","journal-title":"J Vasc Surg"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.01.045"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.02.052"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2023.02.025"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.05.027"}],"container-title":["Vascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17085381251360074","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17085381251360074","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17085381251360074","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:41:29Z","timestamp":1777707689000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17085381251360074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,8]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/17085381251360074"],"URL":"https:\/\/doi.org\/10.1177\/17085381251360074","relation":{},"ISSN":["1708-5381","1708-539X"],"issn-type":[{"value":"1708-5381","type":"print"},{"value":"1708-539X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,8]]}}}