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22-04-2021

Symptom profiles following combat injury and long-term quality of life: a latent class analysis

Auteurs: Andrew J. MacGregor, Amber L. Dougherty, Edwin W. D’Souza, Cameron T. McCabe, Daniel J. Crouch, James M. Zouris, Jessica R. Watrous, John J. Fraser

Gepubliceerd in: Quality of Life Research | Uitgave 9/2021

Abstract

Purpose

The purpose of this study was to identify symptom profiles among U.S. military personnel within 1 year after combat injury and assess the relationship between the symptom profiles and long-term quality of life (QoL).

Methods

The study sample consisted of 885 military personnel from the Expeditionary Medical Encounter Database who completed (1) a Post-Deployment Health Assessment (PDHA) within 1 year following combat injury in Iraq or Afghanistan, and (2) a survey for the Wounded Warrior Recovery Project (WWRP), a longitudinal study tracking patient-reported outcomes (e.g., QoL) in injured military personnel. Fifteen self-reported symptoms from the PDHA were assessed using latent class analysis to develop symptom profiles. Multivariable linear regression assessed the predictive effect of symptom profiles on QoL using the physical (PCS) and mental (MCS) component summary scores from the 36-Item Short Form Survey included in the WWRP. Time between PDHA and WWRP survey ranged from 4.3 to 10.5 years (M = 6.6, SD = 1.3).

Results

Five distinct symptom profiles were identified: low morbidity (50.4%), multimorbidity (15.6%), musculoskeletal (14.0%), psycho-cognitive (11.1%), and auditory (8.9%). Relative to low morbidity, the multimorbidity (β = − 5.45, p < 0.001) and musculoskeletal (β = − 4.23, p < 0.001) profiles were associated with lower PCS, while the multimorbidity (β = − 4.25, p = 0.002) and psycho-cognitive (β = − 3.02, p = 0.042) profiles were associated with lower MCS.

Conclusion

Multimorbidity, musculoskeletal, and psycho-cognitive symptom profiles were the strongest predictors of lower QoL. These profiles can be employed during screening to identify at-risk service members and assist with long-term clinical planning, while factoring in patient-specific impairments and preferences.

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Titel: Symptom profiles following combat injury and long-term quality of life: a latent class analysis
Auteurs: Andrew J. MacGregor
Amber L. Dougherty
Edwin W. D’Souza
Cameron T. McCabe
Daniel J. Crouch
James M. Zouris
Jessica R. Watrous
John J. Fraser
Publicatiedatum: 22-04-2021
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 9/2021
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-021-02836-y

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Symptom profiles following combat injury and long-term quality of life: a latent class analysis

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