Article

The goals of rehabilitation after major limb loss include not only functional
restoration but also a return to a high quality of life (QOL). Few studies have
identified which factors are associated with QOL in veterans and servicemembers
with combat-associated major limb loss. We enrolled Vietnam and Operation Iraqi
Freedom/Operation Enduring Freedom (OIF/OEF) veterans and servicemembers in a
national survey on prosthetic device use. In the Vietnam group, multivariate
analysis found multiple limb loss (adjusted odds ratio [aOR] = 3.1, 95%
confidence interval [CI] = 1.57-6.02) and satisfaction with current prostheses
(aOR = 1.2, 95% CI = 1.05-1.38) are associated with better overall QOL, while a
higher amputation impact rank (aOR = 0.66, 95% CI = 0.59-0.74) and depression
(aOR = 0.21, 95% CI = 0.08-0.54) are associated with worse overall QOL. In the
OIF/OEF group, three factors are significantly associated with worse overall QOL:
combat-associated head injury (aOR = 0.78, 95% CI = 0.61-0.99), combat-associated
injury to the nonamputated limb (aOR = 0.71, 95% CI = 0.57-0.88), and assistance
needed in daily living (aOR = 0.12, 95% CI = 0.02-0.72). Improving satisfaction
with prosthetic devices, improving mental health care, and treating other
combat-associated injuries may significantly improve the overall QOL for these
veterans and servicemembers.

Langue : ANGLAIS