title: Effect of traumatic brain injury among U.S. servicemembers with amputation.
abstract: Servicemembers with combat-related limb loss often require substantial rehabilitative care. The prevalence of traumatic brain injury (TBI), which may impair cognitive and functional abilities, among servicemembers has increased. The primary objectives of this study were to determine the frequency of TBI among servicemembers with traumatic amputation and examine whether TBI status was associated with discharge to civilian status and medical and rehabilitative service use postamputation. U.S. servicemembers who had a combat-related amputation while deployed in Iraq or Afghanistan between 2001 and 2006 were followed for 2 yr postamputation. Data collected includes injury mechanism; postinjury complications; Injury Severity Score (ISS); and follow-up data, including military service discharge status and number of medical, physical, occupational therapy, and prosthetic-related visits. Of the 546 servicemembers with combat-related amputations, 127 (23.3%) had a TBI diagnosis. After adjusting for ISS and amputation location, those with TBI had a significantly greater mean number of medical and rehabilitative outpatient and inpatient visits combined (p < 0.01). Those with TBI were also at greater odds of developing certain postinjury complications. We recommend that providers treating servicemembers with limb loss should assess for TBI because those who sustained TBI required increased medical and rehabilitative care.
authors.affiliation: Naval Health Research Center, Warfighter Performance Department, 140 Sylvester Rd, San Diego, CA 92106, USA. mrauh@mail.sdsu.edu
authors.forename: Mitchell J
authors.initials: MJ
authors.lastname: Rauh
authors.forename: Hilary J
authors.initials: HJ
authors.lastname: Aralis
authors.forename: Ted
authors.initials: T
authors.lastname: Melcer
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Macera
authors.forename: Pinata
authors.initials: P
authors.lastname: Sessoms
authors.forename: Jamie
authors.initials: J
authors.lastname: Bartlett
authors.forename: Michael R
authors.initials: MR
authors.lastname: Galarneau
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000553:Ambulatory Care / Q000706:statistics & numerical data; D000673:Amputation, Traumatic / Q000150:complications* / Q000534:rehabilitation*; D000674:Amputees / Q000534:rehabilitation / Q000706:statistics & numerical data; D000740:Anemia / Q000209:etiology; D001132:Arm; D001424:Bacterial Infections / Q000209:etiology; D001753:Blast Injuries / Q000150:complications; D001930:Brain Injuries / Q000150:complications*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D054542:Iraq War, 2003-2011; D007866:Leg; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data*; D009788:Occupational Therapy / Q000706:statistics & numerical data*; D010591:Phantom Limb / Q000209:etiology; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult