INCREASED CARDIOVASCULAR-DISEASE MORTALITY-RATES IN TRAUMATIC LOWER-LIMB AMPUTEES

We evaluated the 24-year mortality rates of male traumatic lower limb amputees (n = 201) of the Israeli army, wounded between 1948 and 1974 compared with a cohort sample representing the general population (n = 1,832). Mortality rates were significantly higher (21.9% vs 12.1%, p <0.001) in amputees than in controls. Cardiovascular disease (CVD) mor tality was the main cause for this difference. The prevalence of selec ted risk factors for CVD was determined in 101 surviving amputees (age d 50 to 65 years) and a sample of the controls (n = 96) matched by age and ethnic origin. Amputees had higher plasma insulin levels (during Casting and in response to oral glucose loading) and increased blood c oagulation activity. No differences were found in rates of current sym ptoms of ischemic heart disease or of cerebrovascular disease, obesity , hypertension, altered plasma lipoprotein profile, impaired physical activity, smoking, or nutritional habits. Traumatic lower limb amputee s had increased mortality rates due to CVD. Surviving amputees had hyp erinsulinemia, increased coagulability, and increased sympathetic and parasympathetic responses (described previously). These established CV D risk factors may explain the excess mortality due to CVD in traumati c amputees. (C) 1998 by Excerpta Medica, Inc.