VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration
Identifieur interne : 001637 ( Main/Exploration ); précédent : 001636; suivant : 001638VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration
Auteurs : Paula K. Shireman [États-Unis] ; Todd E. Rasmussen [États-Unis] ; Carlos A. Jaramillo [États-Unis] ; Mary Jo Pugh [États-Unis]Source :
- BMC Surgery [ 1471-2482 ] ; 2015.
Abstract
Limb injuries comprise 50-60% of U.S. Service member’s casualties of wars in Afghanistan and Iraq. Combat-related vascular injuries are present in 12% of this cohort, a rate 5 times higher than in prior wars. Improvements in medical and surgical trauma care, including initial in-theatre limb salvage approaches (IILS) have resulted in improved survival and fewer amputations, however, the long-term outcomes such as morbidity, functional decline, and risk for late amputation of salvaged limbs using current process of care have not been studied. The long-term care of these injured warfighters poses a significant challenge to the Department of Defense (DoD) and Department of Veterans Affairs (VA).
The VA Vascular Injury Study (VAVIS): VA-DoD Extremity Injury Outcomes Collaborative, funded by the VA, Health Services Research and Development Service, is a longitudinal cohort study of Veterans with vascular extremity injuries. Enrollment will begin April, 2015 and continue for 3 years. Individuals with a validated extremity vascular injury in the Department of Defense Trauma Registry will be contacted and will complete a set of validated demographic, social, behavioral, and functional status measures during interview and online/ mailed survey. Primary outcome measures will: 1) Compare injury, demographic and geospatial characteristics of patients with IILS and identify late vascular surgery related limb complications and health care utilization in Veterans receiving VA vs. non-VA care, 2) Characterize the preventive services received by individuals with vascular repair and related outcomes, and 3) Describe patient-reported functional outcomes in Veterans with traumatic vascular limb injuries.
This study will provide key information about the current process of care for Active Duty Service members and Veterans with polytrauma/vascular injuries at risk for persistent morbidity and late amputation. The results of this study will be the first step for clinicians in VA and military settings to generate evidence-based treatment and care approaches to these injuries. It will identify areas where rehabilitation medicine and vascular specialty care or telehealth options are needed to allow for better planning, resource utilization, and improved DoD-to-VA care transitions.
Url:
DOI: 10.1186/1471-2482-15-13
PubMed: 25644593
PubMed Central: 4328065
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration</title><author><name sortKey="Shireman, Paula K" sort="Shireman, Paula K" uniqKey="Shireman P" first="Paula K" last="Shireman">Paula K. Shireman</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Surgery, Sam and Ann Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center San Antonio, The South Texas Veterans Health Care System, 7703 Floyd Curl Drive, MC 7790, San Antonio, TX 78229-3900 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Surgery, Sam and Ann Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center San Antonio, The South Texas Veterans Health Care System, 7703 Floyd Curl Drive, MC 7790, San Antonio</wicri:cityArea></affiliation></author><author><name sortKey="Rasmussen, Todd E" sort="Rasmussen, Todd E" uniqKey="Rasmussen T" first="Todd E" last="Rasmussen">Todd E. Rasmussen</name><affiliation wicri:level="2"><nlm:aff id="Aff3">US Combat Casualty Care Research Program, Fort Detrick, Frederick, MD 21702-5012 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>US Combat Casualty Care Research Program, Fort Detrick, Frederick</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff4">The Uniformed Services University, Bethesda, MD 20814 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>The Uniformed Services University, Bethesda</wicri:cityArea></affiliation></author><author><name sortKey="Jaramillo, Carlos A" sort="Jaramillo, Carlos A" uniqKey="Jaramillo C" first="Carlos A" last="Jaramillo">Carlos A. Jaramillo</name><affiliation wicri:level="2"><nlm:aff id="Aff5">Department of Rehabilitation Medicine, University of Texas Health Science Center San Antonio, Polytrauma Rehabilitation Center, South Texas Veterans Healthcare System, 7400 Merton Minter BLVD, San Antonio, TX 78229 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Rehabilitation Medicine, University of Texas Health Science Center San Antonio, Polytrauma Rehabilitation Center, South Texas Veterans Healthcare System, 7400 Merton Minter BLVD, San Antonio</wicri:cityArea></affiliation></author><author><name sortKey="Pugh, Mary Jo" sort="Pugh, Mary Jo" uniqKey="Pugh M" first="Mary Jo" last="Pugh">Mary Jo Pugh</name><affiliation wicri:level="2"><nlm:aff id="Aff6">Department of Epidemiology and Biostatistics, University of Texas Health Science Center San Antonio, The South Texas Veterans Health Care System, 7400 Merton Minter BLVD, San Antonio, TX 78229 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Epidemiology and Biostatistics, University of Texas Health Science Center San Antonio, The South Texas Veterans Health Care System, 7400 Merton Minter BLVD, San Antonio</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25644593</idno><idno type="pmc">4328065</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4328065</idno><idno type="RBID">PMC:4328065</idno><idno type="doi">10.1186/1471-2482-15-13</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000C87</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000C87</idno><idno type="wicri:Area/Pmc/Curation">000C86</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000C86</idno><idno type="wicri:Area/Pmc/Checkpoint">000D30</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000D30</idno><idno type="wicri:Area/Ncbi/Merge">006F86</idno><idno type="wicri:Area/Ncbi/Curation">006F86</idno><idno type="wicri:Area/Ncbi/Checkpoint">006F86</idno><idno type="wicri:Area/Main/Merge">001639</idno><idno type="wicri:Area/Main/Curation">001637</idno><idno type="wicri:Area/Main/Exploration">001637</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">VA Vascular Injury Study (VAVIS): VA-DoD extremity injury outcomes collaboration</title><author><name sortKey="Shireman, Paula K" sort="Shireman, Paula K" uniqKey="Shireman P" first="Paula K" last="Shireman">Paula K. Shireman</name><affiliation wicri:level="2"><nlm:aff id="Aff2">Department of Surgery, Sam and Ann Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center San Antonio, The South Texas Veterans Health Care System, 7703 Floyd Curl Drive, MC 7790, San Antonio, TX 78229-3900 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Surgery, Sam and Ann Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center San Antonio, The South Texas Veterans Health Care System, 7703 Floyd Curl Drive, MC 7790, San Antonio</wicri:cityArea></affiliation></author><author><name sortKey="Rasmussen, Todd E" sort="Rasmussen, Todd E" uniqKey="Rasmussen T" first="Todd E" last="Rasmussen">Todd E. Rasmussen</name><affiliation wicri:level="2"><nlm:aff id="Aff3">US Combat Casualty Care Research Program, Fort Detrick, Frederick, MD 21702-5012 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>US Combat Casualty Care Research Program, Fort Detrick, Frederick</wicri:cityArea></affiliation><affiliation wicri:level="2"><nlm:aff id="Aff4">The Uniformed Services University, Bethesda, MD 20814 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>The Uniformed Services University, Bethesda</wicri:cityArea></affiliation></author><author><name sortKey="Jaramillo, Carlos A" sort="Jaramillo, Carlos A" uniqKey="Jaramillo C" first="Carlos A" last="Jaramillo">Carlos A. Jaramillo</name><affiliation wicri:level="2"><nlm:aff id="Aff5">Department of Rehabilitation Medicine, University of Texas Health Science Center San Antonio, Polytrauma Rehabilitation Center, South Texas Veterans Healthcare System, 7400 Merton Minter BLVD, San Antonio, TX 78229 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Rehabilitation Medicine, University of Texas Health Science Center San Antonio, Polytrauma Rehabilitation Center, South Texas Veterans Healthcare System, 7400 Merton Minter BLVD, San Antonio</wicri:cityArea></affiliation></author><author><name sortKey="Pugh, Mary Jo" sort="Pugh, Mary Jo" uniqKey="Pugh M" first="Mary Jo" last="Pugh">Mary Jo Pugh</name><affiliation wicri:level="2"><nlm:aff id="Aff6">Department of Epidemiology and Biostatistics, University of Texas Health Science Center San Antonio, The South Texas Veterans Health Care System, 7400 Merton Minter BLVD, San Antonio, TX 78229 USA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Texas</region></placeName><wicri:cityArea>Department of Epidemiology and Biostatistics, University of Texas Health Science Center San Antonio, The South Texas Veterans Health Care System, 7400 Merton Minter BLVD, San Antonio</wicri:cityArea></affiliation></author></analytic><series><title level="j">BMC Surgery</title><idno type="eISSN">1471-2482</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Limb injuries comprise 50-60% of U.S. Service member’s casualties of wars in Afghanistan and Iraq. Combat-related vascular injuries are present in 12% of this cohort, a rate 5 times higher than in prior wars. Improvements in medical and surgical trauma care, including initial in-theatre limb salvage approaches (IILS) have resulted in improved survival and fewer amputations, however, the long-term outcomes such as morbidity, functional decline, and risk for late amputation of salvaged limbs using current process of care have not been studied. The long-term care of these injured warfighters poses a significant challenge to the Department of Defense (DoD) and Department of Veterans Affairs (VA).</p></sec><sec><title>Methods/Design</title><p>The VA Vascular Injury Study (VAVIS): VA-DoD Extremity Injury Outcomes Collaborative, funded by the VA, Health Services Research and Development Service, is a longitudinal cohort study of Veterans with vascular extremity injuries. Enrollment will begin April, 2015 and continue for 3 years. Individuals with a validated extremity vascular injury in the Department of Defense Trauma Registry will be contacted and will complete a set of validated demographic, social, behavioral, and functional status measures during interview and online/ mailed survey. Primary outcome measures will: 1) Compare injury, demographic and geospatial characteristics of patients with IILS and identify late vascular surgery related limb complications and health care utilization in Veterans receiving VA vs. non-VA care, 2) Characterize the preventive services received by individuals with vascular repair and related outcomes, and 3) Describe patient-reported functional outcomes in Veterans with traumatic vascular limb injuries.</p></sec><sec><title>Discussion</title><p>This study will provide key information about the current process of care for Active Duty Service members and Veterans with polytrauma/vascular injuries at risk for persistent morbidity and late amputation. The results of this study will be the first step for clinicians in VA and military settings to generate evidence-based treatment and care approaches to these injuries. It will identify areas where rehabilitation medicine and vascular specialty care or telehealth options are needed to allow for better planning, resource utilization, and improved DoD-to-VA care transitions.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Hughes, Cw" uniqKey="Hughes C">CW Hughes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rich, Nm" uniqKey="Rich N">NM Rich</name></author><author><name sortKey="Baugh, Jh" uniqKey="Baugh J">JH Baugh</name></author><author><name sortKey="Hughes, Cw" uniqKey="Hughes C">CW Hughes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sayer, Na" uniqKey="Sayer N">NA Sayer</name></author><author><name sortKey="Chiros, Ce" uniqKey="Chiros C">CE Chiros</name></author><author><name sortKey="Sigford, B" uniqKey="Sigford B">B Sigford</name></author><author><name sortKey="Scott, S" uniqKey="Scott S">S 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D" uniqKey="Nadler D">D Nadler</name></author><author><name sortKey="Tushman, M" uniqKey="Tushman M">M Tushman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bivand, Rs" uniqKey="Bivand R">RS Bivand</name></author><author><name sortKey="Pebesma, Ej" uniqKey="Pebesma E">EJ Pebesma</name></author><author><name sortKey="Gomez, Rv" uniqKey="Gomez R">RV Gomez</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ward, M" uniqKey="Ward M">M Ward</name></author><author><name sortKey="Gleditsch, K" uniqKey="Gleditsch K">K Gleditsch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Burgess, Jf" uniqKey="Burgess J">JF Burgess</name></author><author><name sortKey="Defiore, Da" uniqKey="Defiore D">DA DeFiore</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Liang, Ky" uniqKey="Liang K">KY Liang</name></author><author><name sortKey="Zeger, Sl" uniqKey="Zeger S">SL Zeger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stuart, Ea" uniqKey="Stuart E">EA Stuart</name></author><author><name sortKey="Stephen, R" uniqKey="Stephen R">R Stephen</name></author><author><name sortKey="Cole, Sr" uniqKey="Cole S">SR Cole</name></author><author><name sortKey="Bradshaw, Cp" uniqKey="Bradshaw C">CP Bradshaw</name></author><author><name sortKey="Leaf, Pj" uniqKey="Leaf P">PJ Leaf</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Maryland</li><li>Texas</li></region></list><tree><country name="États-Unis"><region name="Texas"><name sortKey="Shireman, Paula K" sort="Shireman, Paula K" uniqKey="Shireman P" first="Paula K" last="Shireman">Paula K. Shireman</name></region><name sortKey="Jaramillo, Carlos A" sort="Jaramillo, Carlos A" uniqKey="Jaramillo C" first="Carlos A" last="Jaramillo">Carlos A. Jaramillo</name><name sortKey="Pugh, Mary Jo" sort="Pugh, Mary Jo" uniqKey="Pugh M" first="Mary Jo" last="Pugh">Mary Jo Pugh</name><name sortKey="Rasmussen, Todd E" sort="Rasmussen, Todd E" uniqKey="Rasmussen T" first="Todd E" last="Rasmussen">Todd E. Rasmussen</name><name sortKey="Rasmussen, Todd E" sort="Rasmussen, Todd E" uniqKey="Rasmussen T" first="Todd E" last="Rasmussen">Todd E. Rasmussen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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