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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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Wenger, J. W., O’Connell, C., & Cottrell, L. (2018). Examination of recent deployment experience across the services and components. RAND Corporation. https://www.rand.org/pubs/research_reports/RR1928.html. Accessed 13 September 2020.

MacGregor, A. J., Han, P. P., Dougherty, A. L., & Galarneau, M. R. (2012). Effect of dwell time on the mental health of US military personnel with multiple combat tours. American Journal of Public Health, 102(Suppl 1), S55–S59. PubMedPubMedCentralCrossRef

Goldberg, M. S. (2014). Updated death and injury rate of U.S. military personnel during the conflicts in Iraq and Afghanistan. Working Paper 2014–08. Congressional Budget Office. https://www.cbo.gov/sites/default/files/113th-congress-2013-2014/workingpaper/49837-Casualties_WorkingPaper-2014-08_1.pdf. Accessed 13 September 2020.

Belmont, L. P. J. (2010). Epidemiology of combat wounds in operation iraqi freedom and operation enduring freedom: orthopaedic burden of disease. Journal of Surgical Orthopaedic Advances, 19(1), 2–7. PubMed

Eskridge, S. L., Macera, C. A., Galarneau, M. R., Holbrook, T. L., Woodruff, S. I., MacGregor, A. J., et al. (2012). Injuries from combat explosions in Iraq: Injury type, location, and severity. Injury, 43(10), 1678–1682. PubMedCrossRef

Howard, J. T., Kotwal, R. S., Stern, C. A., Janak, J. C., Mazuchowski, E. L., Butler, F. K., et al. (2019). Use of combat casualty care data to assess the US military trauma system during the Afghanistan and Iraq conflicts, 2001–2017. JAMA Surgery, 154(7), 600–608. PubMedPubMedCentralCrossRef

Watrous, J. R., Dougherty, A. L., McCabe, C. T., Sack, D. I., & Galarneau, M. R. (2019). The Wounded Warrior Recovery Project: A longitudinal examination of patient-reported outcomes among deployment-injured military personnel. Military Medicine, 184(3–4), 84–89. PubMedCrossRef

Woodruff, S. I., Galarneau, M. R., McCabe, C. T., Sack, D. I., & Clouser, M. C. (2018). Health-related quality of life among US military personnel injured in combat: findings from the wounded warrior recovery project. Quality of Life Research, 27(5), 1393–1402. PubMedCrossRef

MacGregor, A. J., Shaffer, R. A., Dougherty, A. L., Galarneau, M. R., Raman, R., Baker, D. G., et al. (2009). Psychological correlates of battle and nonbattle injury among operation Iraqi freedom veterans. Military Medicine, 174(3), 224–231. PubMedCrossRef

10.

Stucki, G. (2005). International Classification of Functioning, Disability, and Health (ICF): A promising framework and classification for rehabilitation medicine. American Journal of Physical Medicine Rehabilitation, 84, 733–740. PubMedCrossRef

11.

Wounded Warrior Project. 2019 Annual Warrior Survey. https://www.woundedwarriorproject.org/mission/annual-warrior-survey. Accessed 13 September 2020.

12.

Congressional Budget Office. (2014). Veterans’ disability compensation: Trends and policy options. Congress of the United States. http://www.cbo.gov/sites/default/files/cbofiles/attachments/45615-VADisability_1.pdf. Accessed 13 September 2020.

13.

Kelton, M. L., LeardMann, C. A., Smith, B., et al. (2010). Exploratory factor analysis of self-reported symptoms in a large, population-based military cohort. BMC Medical Research Methodology, 15(10), 94. https://doi.org/10.1186/1471-2288-10-94. CrossRef

14.

Jones, E., Hodgins-Vermaas, R., McCartney, H., Everitt, B., Beech, C., Poynter, D., Palmer, I., Hyams, K., & Wessely, S. (2002). Post-combat syndromes from the Boer war to the Gulf war: a cluster analysis of their nature and attribution. BMJ, 324(7333), 321–324. PubMedPubMedCentralCrossRef

15.

Graham, K., Searle, A., Van Hooff, M., Lawrence-Wood, E., & McFarlane, A. (2020). The value of physical symptoms in screening for posttraumatic stress disorder in the military. Assessment, 27(6), 1139–1150. PubMedCrossRef

16.

Galarneau, M. R., Hancock, W. C., Konoske, P., Melcer, T., Vickers, R. R., Walker, G. J., et al. (2006). The navy-marine corps combat trauma registry. Military Medicine, 171, 691–697. PubMedCrossRef

17.

Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA, 295(9), 1023–1032. PubMedCrossRef

18.

Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007). Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA, 298(18), 2141–2148. PubMedCrossRef

19.

Aralis, H. J., Macera, C. A., Rauh, M. J., & MacGregor, A. J. (2014). Traumatic brain injury and PTSD screening efforts evaluated using latent class analysis. Rehabilitation Psychology, 59(1), 68–78. PubMedCrossRef

20.

Baker, S. P., O’Neill, B., Haddon, W., Jr., & Long, W. B. (1974). The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care. Journal of Trauma, 14, 187–196. CrossRefPubMed

21.

Copes, W. S., Champion, H. R., Sacco, W. J., Lawnick, M. M., Keast, S. L., & Bain, L. W. (1988). The injury severity score revisited. Journal of Trauma, 28, 69–77. CrossRefPubMed

22.

Barell, V., Aharonson-Daniel, L., Fingerhut, L. A., Mackenzie, E. J., Ziv, A., Boyko, V., et al. (2002). An introduction to the Barell body region by nature of injury diagnosis matrix. Injury Prevention, 8(2), 91–96. PubMedPubMedCentralCrossRef

23.

Prins, A., Quimette, P., Kimerling, R., Cameron, R. P., Hugelshofer, D. S., Shaw-Heger, J., et al. (2003). The primary care PTSD screen (PC-PTSD): Development and operating characteristics. Primary Care Psychiatry, 9, 9–14. CrossRef

24.

Bliese, P. D., Wright, K. M., Adler, A. B., Cabrera, O., Castro, C. A., & Hoge, C. W. (2008). Validating the primary care posttraumatic stress disorder screen and the posttraumatic stress disorder checklist with soldiers returning from combat. Journal of Consulting Clinical Psychology, 76(2), 272–281. PubMedCrossRef

25.

Ware, J. E., & Kosinski, M. (2001). SF-36 physical & mental health summary scales: A manual for users of version 1. (2nd ed.). Lincoln, RI: Quality Metric Incorporated.

26.

Ware, J. E., Kosinski, M., & Keller, S. D. (1994). SF-36 physical and mental health summary scales: A user’s manual. . Boston, MA: Health Assessment Lab.

27.

Smith, T. C., Zamorski, M., Smith, B., Riddle, J. E., LeardMann, C. A., Wells, T. S., et al. (2007). The physical and mental health of a large military cohort: Baseline functional health status of the Millennium Cohort. BMC Public Health, 7, 340. PubMedPubMedCentralCrossRef

28.

The comprehensive R archive network. Polytomous variable latent class analysis (poLCA). https://CRAN.R-project.org/package=poLCA. Accessed 13 September 2020.

29.

Clark, S. L., & Muthén, B. (2009). Relating latent class analysis results to variables not included in the analysis. University of California, Los Angeles. https://www.statmodel.com/download/relatinglca.pdf. Accessed 13 September 2020.

30.

Masyn, K. E. (2013). Latent class analysis and finite mixture modeling. In T. D. Little (Ed.). The Oxford handbook of quantitative methods: Statistical analysis (pp. 551–611). Oxford University Press.

31.

MacGregor, A. J., Zouris, J. M., Watrous, J. R., McCabe, C. T., Dougherty, A. L., Galarneau, M. R., et al. (2020). Multimorbidity and quality of life after blast-related injury among US military personnel: A cluster analysis of retrospective data. BMC Public Health, 20(1), 578. PubMedPubMedCentralCrossRef

32.

Kanesarajah, J., Waller, M., Whitty, J. A., & Mishra, G. D. (2018). Multimorbidity and quality of life at mid-life: A systematic review of general population studies. Maturitas, 109, 53–62. PubMedCrossRef

33.

Lew, H. L., Otis, J. D., Tun, C., Kerns, R. D., Clark, M. E., & Cifu, D. X. (2009). Prevalence of chronic pain, posttraumatic stress disorder, and persistent postconcussive symptoms in OIF/OEF veterans: Polytrauma clinical triad. Journal of Rehabilitation Research & Development, 46, 697–702. CrossRef

34.

Cifu, D. X., Taylor, B. C., Carne, W. F., Bidelspach, D., Sayer, N. A., Scholten, J., et al. (2013). Traumatic brain injury, posttraumatic stress disorder, and pain diagnoses in OIF/OEF/OND Veterans. Journal of Rehabilitation Research & Development, 50, 1169–1176. CrossRef

35.

Watrous, J. R., McCabe, C. T., Jones, G., Farrokhi, S., Mazzone, B., Clouser, M. C., et al. (2020). Low back pain, mental health symptoms, and quality of life among injured service members. Health Psychology, 39(7), 549–557. PubMedCrossRef

36.

Silverberg, N. D., Wojtowicz, M., Bui, E., Wershba, R., Zafonte, R., Laifer, L. M., et al. (2017). Contribution of perceived cognitive functioning to quality of life in service members and veterans with posttraumatic stress disorder. Journal of Trauma Stress, 30(3), 318–322. CrossRef

37.

Porter, B., Bonanno, G. A., Bliese, P. D., Phillips, C. J., & SP Proctor for the Millennium Cohort Study. (2019). Combat and trajectories of physical health functioning in US service members. American Journal of Preventive Medicine, 57(5), 637–644. PubMedCrossRef

38.

Isaacs, K., Mota, N. P., Tsai, J., Harpaz-Rotem, I., Cook, J. M., Kirwin, P. D., et al. (2017). Psychological resilience in U.S. military veterans: A 2-year, nationally representative prospective cohort study. Journal of Psychiatric Research, 84, 301–309. PubMedCrossRef

39.

Fraser, J. J., Schmied, E., Rosenthal, M. D., & Davenport, T. E. (2020). Physical therapy as a force multiplier: Population health perspectives to address short-term readiness and long-term health of military service members. Cardiopulmonary Physical Therapy Journal, 31(1), 22–28. CrossRef

40.

Armed Forces Health Surveillance Center. (2010). Insomnia, active component, U.S. Armed Forces, January 2000-December 2009. Medical Surveillance Monthly Report, 17(5), 12–15.

41.

Medic, G., Wille, M., & Hemels, M. E. (2017). Short- and long-term health consequences of sleep disruption. Nature and Science of Sleep, 19, 151–161. CrossRef

42.

Wang, H. E., Campbell-Sills, L., Kessler, R. C., Sun, X., Heeringa, S. G., Nock, M. K., et al. (2019). Pre-deployment insomnia is associated with post-deployment post-traumatic stress disorder and suicidal ideation in US Army soldiers. Sleep, 42(2), zxy229. CrossRef

43.

Luxton, D. D., Greenburg, D., Ryan, J., Niven, A., Wheeler, G., & Mysliwiec, V. (2011). Prevalence and impact of short sleep duration in redeployed OIF soldiers. Sleep, 34, 1189–1195. PubMedPubMedCentralCrossRef

44.

Test, T., Canfi, A., Eyal, A., Shoam-Vardi, I., & Sheiner, E. K. (2011). The influence of hearing impairment on sleep quality among workers exposed to harmful noise. Sleep, 34(1), 25–30. PubMedPubMedCentralCrossRef

45.

Simonelli, G., Mantua, J., Gad, M., St. Pierre, M., Moore, L., Yarnell, A. M., et al. (2018). Sleep extension reduces pain sensitivity. Sleep Medicine, 54, 172–176. PubMedCrossRef

46.

Schwab, K., Terrio, H. P., Brenner, L. A., Pazdan, R. M., McMillan, H. P., MacDonald, M., et al. (2017). Epidemiology and prognosis of mild traumatic brain injury in returning soldiers: A cohort study. Neurology, 88(16), 1571–1579. PubMedCrossRef

47.

Seelig, A. D., Jacobson, I. G., Smith, B., Hooper, T. I., Boyko, E. J., Gackstetter, G. D., et al. (2010). Sleep patterns before, during, and after deployment to Iraq and Afghanistan. Sleep, 33, 1615–1622. PubMedPubMedCentralCrossRef

48.

Rabinowitz, Y. G., Breitbach, J. E., & Warner, C. H. (2009). Managing aviator fatigue in a deployed environment: The relationship between fatigue and neurocognitive functioning. Military Medicine, 174, 358–362. PubMedCrossRef

49.

Boehmer, T. K., Boothe, V. L., Flanders, W. D., & Barrett, D. H. (2003). Health-related quality of life of U.S. military personnel A population-based study. Military Medicine, 168(11), 941–947. PubMedCrossRef

50.

LeardMann, C. A., Kelton, M. L., Smith, B., Littman, A. J., Boyko, E. J., Wells, T. S., et al. (2011). Prospectively assessed posttraumatic stress disorder and associated physical activity. Public Health Reports, 126(3), 371–383. PubMedPubMedCentralCrossRef

51.

Hegberg, N. J., Hayes, J. P., & Hayes, S. M. (2019). Exercise intervention in PTSD: A narrative review and rationale for implementation. Frontiers in Psychiatry, 10, 133. PubMedPubMedCentralCrossRef

52.

Kendall-Tackett, K. (2009). Psychological trauma and physical health: A psychoneuroimmunology approach to etiology of negative health effects and possible interventions. Psychological Trauma: Theory, Research, Practice, and Policy, 1(1), 35–48. CrossRef

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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