Janbazan Medical and Engineering Research Center (JMERC), NO.17, Farrokh St., Moghaddas Ardebily Ave., Chamran Highway, Tehran, Iran.
Mil Med Res. 2017 Nov 29;4(1):37. doi: 10.1186/s40779-017-0146-1.
The ankle-foot injuries are among the war-related injuries that cause many serious secondary problems for a lifetime. This nationwide study aimed to assess health-related quality of life and the ability to perform activities of daily living in veterans with ankle-foot injuries due to the Iran-Iraq war.
A total of 1079 veterans with ankle-foot injuries were enrolled in a cross-sectional study from 2014 to 2016. Demographic characteristics, including age, gender, marital status, disability percent, educational level, employment and additional injuries, were collected. The ability to perform daily activities was assessed using the Barthel activities of daily living (ADL) and Lawton instrumental activities of daily living (IADL) Indexes. Physical and mental health-related quality of life (HRQOL) data were measured via the SF-36 subscales. The data were compared with those of bilateral lower limb amputees (BLLAs) and of the general Iranian population. Statistical analyses, including Pearson's correlation coefficient, one-sample t-test and analysis of variance (ANOVA), were performed using SPSS16.0. A multiple linear regression model was used to determine the contribution of independent variables to the Physical Component Summary (PCS) and Mental Component Summary (MCS).
The highest and lowest scores were observed for mental health (48.93 ± 20.69) and bodily pain (28.16 ± 21.74), respectively. The mean scores of veterans with ankle-foot injuries on the SF-36 were significantly lower on all eight measures than those of the general Iranian male population and of the bilateral lower limb amputees (P < 0.001). The mean scores of ADLs and IADLs were 83.9 ± 16.3 and 5.3 ± 2.0, respectively. The higher dependency in ADLs (P < 0.001) and IADLs (P < 0.001), the higher disability rate (P < 0.001) and additional injury (P < 0.001) were significant determinants of the PCS. ADL (P < 0.001) and IADL (P < 0.001) limitations, additional injury (P < 0.001), history of hospitalization in the year preceding the study (P = 0.007) and employment (P = 0.001) were reported as determinants of the MCS.
The results strongly suggest that veterans with ankle-foot injuries suffer from critically poor health-related quality of life. The main predicting factors of HRQOL were the disability to perform ADLs/IADLs, suffering two or more injuries, a history of hospitalization in the year preceding the study and unemployment.
踝关节足部损伤是与战争相关的损伤之一，会导致许多终身严重的继发性问题。本全国性研究旨在评估因两伊战争而患有踝关节足部损伤的退伍军人的健康相关生活质量和日常生活活动能力。
2014 年至 2016 年期间，共有 1079 名踝关节足部损伤退伍军人参与了这项横断面研究。收集了人口统计学特征，包括年龄、性别、婚姻状况、残疾百分比、教育水平、就业和其他损伤。日常生活活动能力通过 Barthel 日常生活活动（ADL）和 Lawton 工具性日常生活活动（IADL）指数进行评估。通过 SF-36 子量表测量身体和心理健康相关生活质量（HRQOL）数据。将数据与双侧下肢截肢者（BLLA）和伊朗普通人群进行比较。使用 SPSS16.0 进行包括 Pearson 相关系数、单样本 t 检验和方差分析（ANOVA）在内的统计分析。使用多元线性回归模型确定独立变量对生理成分综合评分（PCS）和心理成分综合评分（MCS）的贡献。
精神健康得分最高（48.93±20.69），身体疼痛得分最低（28.16±21.74）。踝关节足部损伤退伍军人在 SF-36 的所有八项测量中得分均显著低于伊朗普通男性和双侧下肢截肢者（P<0.001）。ADL 和 IADL 的平均得分为 83.9±16.3 和 5.3±2.0。ADL（P<0.001）和 IADL（P<0.001）依赖性较高、残疾率较高（P<0.001）和有其他损伤（P<0.001）是 PCS 的显著决定因素。ADL（P<0.001）和 IADL（P<0.001）受限、有其他损伤（P<0.001）、研究前一年住院史（P=0.007）和就业（P=0.001）是 MCS 的决定因素。
结果强烈表明，踝关节足部损伤退伍军人的健康相关生活质量极差。HRQOL 的主要预测因素是 ADL/IADL 活动障碍、有两处或多处损伤、研究前一年有住院史和失业。
