During the Military Health System Research Symposium (MHSRS) Aug. 29, researchers from the Naval Health Research Center (NHRC) shared findings from a recent report that described quality of life outcomes for combat-injured amputees.

The combination of advances in combat medicine and the use of improvised explosive devices in the recent conflicts in Iraq and Afghanistan has resulted in not only the highest battlefield survival rate in military history, but also increasing numbers of U.S. military personnel with amputation of one or more limbs. These seriously injured service members have unique physical and medical challenges that may have long-term consequences for their quality of life.

To better understand these potential consequences and the impact on the health and well-being of military personnel, NHRC researchers with the Wounded Warrior Recovery Project (WWRP), a long-term study examining injury effects on wounded service members' quality of life, conducted an investigation to learn more about the characteristics of this combat-amputee population and examine differences between them and injured service members without amputation.

Researchers found that combat-injured amputees reported significantly lower health-related quality of life (HRQoL) than those without amputations. Specifically, the amputee group reported lower HRQoL in areas of chronic and acute symptoms, mobility, self-care, physical activities, and activities associated with daily living such as going to work or attending school. Additional study findings about combat-injured amputees include:

* 66% sustained immediate amputations (at point of injury or within 24 hours)
* 34% underwent delayed amputations (more than 24 hours post-injury)
* 84% were under the age of 30 at time of injury
* Most of this population were Army (66%) and Marine Corps (30%)
* 90% were injured by a blast
* From 2010 to 2014, 88% were injured while dismounted
* 87% of amputations were lower extremity
* 36% sustained multiple amputations

Researchers from the WWRP analyzed data from 1,767 active duty and veteran service members with at least one combat-related amputation from 2001 to 2016. The data was pulled from the Expeditionary Medical Encounter Database (EMED) - a high-quality data repository developed by scientists at NHRC that provides accurate injury and clinical treatment data for casualties from point of injury to definitive care and rehabilitation.

"These results can help military leaders and decision-makers better understand the characteristics of our combat-injured populations, which can be used to develop recovery and rehabilitation care and treatment, targeted to meet the unique needs of this particular group of injured service members," said Michael Galarneau, the director of operational readiness and health at NHRC and principal investigator for the WWRP.

"Also, by identifying risk factors associated with poorer quality-of-life outcomes and knowing which ones can be changed, military and medical leadership can use that knowledge to design interventions that may improve their overall health and well-being," Galarneau continued.

As the DoD's premier deployment health research center, NHRC's cutting-edge research and development is used to optimize the operational health and readiness of the nation's armed forces. In proximity to more than 95,000 active duty service members, world-class universities, and industry partners, NHRC sets the standard in joint ventures, innovation, and translational research.

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