Woodruff Susan I, Galarneau Michael R, Sack Daniel I, McCabe Cameron T, Dye Judy L
From San Diego State University, School of Social Work, San Diego, California (S.I.W.); and Naval Health Research Center, Medical Modeling, Simulation, and Mission Support Department, Wounded Warrior Recovery Project, San Diego, California (M.R.G., D.I.S., C.T.M., J.L.D.).
J Trauma Acute Care Surg. 2017 Mar;82(3):592-595. doi: 10.1097/TA.0000000000001348.
This study extends what is known about long-term health-related quality of life (HrQoL) and other psychosocial outcomes (i.e., depression, posttraumatic stress disorder [PTSD]) among US military combat amputees serving in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn.
A total of 63 combat amputees were identified from the Wounded Warrior Recovery Project, a study assessing long-term self-reported HrQoL and psychological outcomes among those wounded during military service. Another 477 service members from the Wounded Warrior Recovery Project were identified as a comparison group (i.e., nonamputees with moderate to severe extremity injuries).
After adjusting for age, time since injury, overall injury severity, and traumatic brain injury, amputees had poorer functional HrQoL than those in the nonamputee comparison group overall and in the specific area related to performance of usual activities, and, to some degree, chronic and acute symptoms, and mobility/self-care. On the other hand, depression and PTSD symptoms were not different for the two groups.
Results suggest that when assessed over 5 years postinjury, on average, amputees have unique physical and functional limitations, yet do not report greater depression or PTSD symptoms than others seriously injured in combat. It may be that state-of-the-art integrated amputee care that includes support networks and emphasis on adjustment and psychological health may increase successful coping and adjustment, at least to a level that is on par with other types of serious combat injury.
Epidemiologic/prognostic study, level III.
本研究拓展了我们对在持久自由行动、伊拉克自由行动和新黎明行动中服役的美国军事战斗截肢者的长期健康相关生活质量（HrQoL）及其他心理社会结果（即抑郁、创伤后应激障碍[PTSD]）的了解。
从受伤战士康复项目中识别出63名战斗截肢者，该项目是一项评估服役期间受伤者长期自我报告的HrQoL和心理结果的研究。另外从受伤战士康复项目中识别出477名军人作为对照组（即中度至重度肢体损伤的非截肢者）。
在调整年龄、受伤时间、总体损伤严重程度和创伤性脑损伤因素后，截肢者在总体功能HrQoL方面比非截肢对照组差，在与日常活动表现相关的特定领域，以及在一定程度上的慢性和急性症状及活动能力/自我护理方面也较差。另一方面，两组的抑郁和PTSD症状没有差异。
结果表明，在受伤后5年进行评估时，平均而言，截肢者有独特的身体和功能限制，但与其他在战斗中严重受伤的人相比，并未报告更多的抑郁或PTSD症状。可能是包括支持网络并强调调整和心理健康的先进综合截肢护理，至少可以提高成功应对和调整的能力，达到与其他类型严重战斗损伤相当的水平。
流行病学/预后研究，III级。
