title: Quality of Life in United States Veterans With Combat-Related Ostomies From Iraq and Afghanistan.
abstract: Assess the impact of ostomy formation on quality of life for U.S. Service Members.
  
  
  
  U.S. personnel sustaining colorectal trauma from 2003 to 2011 were identified using the Department of Defense Trauma Registry. A cross-sectional observational study was conducted utilizing prospective interviews with standard survey instruments. Primary outcome measures were the Stoma Quality of Life Scale and Veterans RAND 36 scores and subjective responses. Patients with colorectal trauma not requiring ostomy served as controls.
  
  
  
  Of 177 available patients, 90 (50.8%) male veterans consented to participate (55 ostomy, 35 control). No significant differences were observed between ostomy and control groups for Injury Severity Score (25.6 ± 9.9 vs. 22.9 ± 11.8, p = 0.26) or mechanism of injury (blast: 55 vs. 52%, p = 0.75); nonostomates had fewer anorectal injuries (3.2 vs. 47.9%, p < 0.01). Median follow-up was 6.7 years. Veterans RAND-36 Physical and Mental Component Scores were similar between groups. About 45.8% of ostomates were willing-to-trade a median of 10 years (interquartile range = 5-15) of their remaining life for gastrointestinal continuity. At last follow-up, 95.9% of respondents' combat-related ostomies were reversed with a median duration of 6 (range = 3-19) months diverted.
  
  
  
  Ostomy creation in a combat environment remains safe and does not have a quantifiable impact on long-term quality of life.
authors.affiliation: Department of Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78219.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Clemens
authors.affiliation: Department of Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78219.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Heafner
authors.affiliation: Department of Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78219.
authors.forename: J Devin B
authors.initials: JD
authors.lastname: Watson
authors.affiliation: Department of Epidemiology, U.S. Army Institute of Surgical Research, 3851 Roger Brooke Drive, Fort Sam Houston, TX.
authors.forename: James K
authors.initials: JK
authors.lastname: Aden
authors.affiliation: U.S. Combat Casualty Care Research Program, 504 Scott Street, Fort Detrick, MD 21702.
authors.forename: Todd E
authors.initials: TE
authors.lastname: Rasmussen
authors.affiliation: U.S. Air Force Center for the Sustainment of Trauma and Resuscitation Skills (C-STARS), 3635 Vista at Grand Boulevard, St. Louis, MO 63110.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Glasgow
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D015331:Cohort Studies; D003113:Colonoscopy / Q000009:adverse effects* / Q000523:psychology; D015179:Colorectal Neoplasms / Q000523:psychology / Q000601:surgery; D003430:Cross-Sectional Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology / Q000601:surgery; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D010030:Ostomy / Q000523:psychology* / Q000592:standards / Q000706:statistics & numerical data; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology* / Q000706:statistics & numerical data