Traumatic Ear Amputations: An Analysis of Epidemiology and Treatment Course Based on the National Trauma Data Bank.

Abstract

Traumatic ear amputation (TEA) affects hundreds of Americans each year. However, there is little information regarding epidemiology, risk factors, and treatment for TEA, all of which enhance a surgeon's understanding of TEA and for treatment planning. This study included data from The National Trauma Data Bank (NTDB) collected from the year 2017 to 2021. The variables analyzed included demographics, pre-existing comorbidities, mechanism of TEA, concurrent injuries, inpatient complications, reattachment details, length of stay, and discharge disposition for each subgroup. Descriptive statistics were performed using a χ2 test for categorical variables and a rank-sum test for continuous variables. From 2017 to 2021, 1322 patients in the NTDB experienced TEA. Of those, 15% (198/1322) experienced complete TEA and 85% (1124/1322) had partial TEA. Most patients were white males, ages 25 to 34 years, affected by motor vehicle accidents, and there were no significant demographic differences between the partial and complete TEA cohorts. The most frequently reported preexisting condition was alcohol use disorder. Reattachment occurred in 13.6% (180/1322) of cases with no difference in reattachment rates between partial and complete TEA. Significantly more females and patients with private insurance underwent reattachment compared with those who did not undergo reattachment. The most commonly co-occurring injury was injury to head and neck and the most common complication was acute kidney injury. This study confirmed that TEA affects primarily young males, and showed that reattachment occurs at a low rate of 13.6% (180/1322), which may be due to co-occurring injuries, microsurgeon availability, and use of other reconstructive techniques.