• Anna L Kratz, Rhonda M Williams, Aaron P Turner, Katherine A Raichle, Doug G Smith, and Dawn Ehde.
• Department of Rehabilitation Medicine, University of Washington, USA.
• Rehabil Psychol. 2010 May 1; 55 (2): 126-38.

ObjectiveTo compare individuals with traumatic (TE) vs. nontraumatic (NTE) amputation etiology on pain, psychological, and social variables over the first 12 months postamputation, and to explore changes in mean levels of and correlations between these variables over time.ParticipantsThere were 111 adults with newly acquired limb loss.SettingsA VA medical center and a Level I trauma hospital in a large metropolitan area.Main Outcome MeasuresCharacteristic Pain Severity, Pain Interference, Patient Health Questionnaire depression module, Posttraumatic Stress Disorder Checklist, Social Constraints Scale, Aversive Emotional Support Scale, Centers for Disease Control and Prevention single item Social Support measure, single item loneliness measure.ResultsThe NTE group was significantly older, had lower income, and had greater medical comorbidity, preamputation pain, and physical disability. The etiology groups did not differ significantly in mean levels of outcome variables except that the TE group reported greater aversive emotional support at 6 and 12 months. The TE group demonstrated a quadratic change in pain interference, with highest levels at 6 months and a linear increase in social constraints. Both etiology groups showed a linear increase in PTSD symptoms over time. Correlations between physical, psychological, and social distress were observed earlier in the year for the NTE group.ConclusionDespite significant demographic and preamputation experience differences, few differences in outcomes emerged by etiology group in the first year after amputation. Findings suggest that the year after amputation may be a time of greater change for those with traumatic amputation compared to those with nontraumatic amputation.

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