Retrospective study of cardiovascular disease risk factors among a cohort of combat veterans with lower limb amputation

Previous studies have shown that veterans with lower limb amputation have a higher risk for cardiovascular disease (CVD) compared with population-based controls. American veterans who have served in Iraq and Afghanistan with lower limb amputation may be at a similarly higher risk. The Navel Health R...

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Bibliographic Details
Published in:Vascular health and risk management 2019-01, Vol.15, p.409-418
Main Authors: Bhatnagar, Vibha, Richard, Erin, Melcer, Ted, Walker, Jay, Galarneau, Michael
Format: Article
Language:English
Subjects:
Adult
Afghan Campaign 2001
Amputation
Amputation - adverse effects
Biomarkers - blood
blood pressure
cardiovascular disease
Cardiovascular Diseases - blood
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - physiopathology
combat injury
Databases, Factual
Department of Veterans Affairs
dyslipidemia
Expeditionary Medical Encounter Database
Female
Health risk assessment
Hemodynamics
Humans
Insulin resistance
Iraq War, 2003-2011
limb amputation
Lipids - blood
Lower Extremity - blood supply
Male
Metabolic disorders
metabolic syndrome
Metabolic Syndrome - blood
Metabolic Syndrome - diagnosis
Metabolic Syndrome - epidemiology
Metabolic Syndrome - physiopathology
Middle Aged
Mortality
Original Research
Post traumatic stress disorder
posttraumatic stress disorder
Prevalence
Preventive medicine
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
United States - epidemiology
United States Department of Veterans Affairs
Vascular System Injuries - diagnosis
Vascular System Injuries - epidemiology
Vascular System Injuries - physiopathology
Vascular System Injuries - surgery
Veterans
Veterans Health
Womens health
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Summary:Previous studies have shown that veterans with lower limb amputation have a higher risk for cardiovascular disease (CVD) compared with population-based controls. American veterans who have served in Iraq and Afghanistan with lower limb amputation may be at a similarly higher risk. The Navel Health Research Center (NHRC) maintains the Expeditionary Medical Encounter Database (EMED) of military personnel who have sustained combat limb amputation or serious limb injury during the conflicts in Iraq and Afghanistan. Department of Veterans Affairs data from 2003 to April 2015 was used to analyze CVD risk factors in this cohort. Veterans with either unilateral (n=442) or bilateral (n 146) lower limb amputation were compared to those with serious lower limb trauma without amputation (n=184). Multivariate regression was used to measure associations between lower limb amputation and CVD risk factors over an average of 8 years of follow-up. Outcomes included mean arterial pressure (MAP), low-density lipoprotein, high-density lipoprotein (HDL), and serum triglycerides (TG). Compared with the limb injury group, those with unilateral lower limb amputation had significantly lower HDL (
ISSN:1178-2048
1176-6344
1178-2048
DOI:10.2147/VHRM.S212729