Epidemiology of Finger Amputations in the United States From 1997 to 2016

Abstract

Purpose: There are minimal long-term epidemiological data focused on finger amputations in the United States (US). We sought to quantify the incidence and trends in finger amputations over a 20-year period, describe mechanisms of injury by age groups, and examine trends in emergency department (ED) disposition. Methods: The National Electronic Injury Surveillance System was queried over a 20-year period (1997–2016) for finger amputations presenting to US EDs. Using US Census data, national incidence rates were estimated. We evaluated specific mechanisms of injury and ranked common mechanisms for each age group. Trends in hospital admission rates were evaluated and predictors of admission were examined using logistical regression. Results: From 1997 to 2016, a weighted estimate of 464,026 patients sustained finger amputations in the US with an estimated yearly incidence of 7.5/100,000 person-years. A bimodal age distribution was seen, with the greatest incidence in children aged less than 5 years and adults over 65 years. Doors were the most common injury mechanism in children (aged less than 5 years), whereas power saws were most common in teens and adults (aged more than 15 years). Over the study period, there was a significant increase in patients admitted to the hospital; however, this increase was not seen among African Americans. Significant predictors of hospital admission included male gender, age less than 18 years, high-energy mechanisms, non–African American race, and very large hospital size, as defined by the National Electronic Injury Surveillance System. Conclusions: The incidence of finger amputations is bimodal; young children (aged less than 5 years) and the elderly (aged greater than 65 years) are at greatest risk. There is a widening disparity between African Americans and non–African Americans in relation to ED disposition. Doors and power saws are the most common mechanisms of injury; however, these affect different age ranges. This study’s results highlight the need for improved age-specific safety guidelines and device safety features. Type of study/level of evidence: Prognostic IV. Key words: epidemiology, finger amputation, NEISS database