Retrospective study of cardiovascular disease risk factors among a cohort of combat veterans with lower limb amputation
Abstract
Previous studies have shown that veterans with lower-limb amputation have a higher risk for cardiovascular disease in comparison to population-based controls. American veterans who have served in Iraq and Afghanistan with lower-limb amputation may be at a similarly higher risk. Patients and Methods. A retrospective review of Department of Veterans Affairs data resources from 2003 to April 2015 were used to analyze cardiovascular risk factors for a cohort of combat veterans injured between 2003 and 2008 from the Naval Health Research Centers Expeditionary Medical Encounter Database. 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 cardiovascular risk factors over an average of eight years of follow-up; outcomes included mean arterial blood pressure (MAP), low density lipoprotein, high density lipoprotein (HDL) and serum triglycerides. In comparison to the limb injury group, those with unilateral lower-limb amputation had significantly lower HDL (p < 0.05) and higher triglycerides (p < 0.05). Those with bilateral lower-limb amputation had significantly higher MAP (p < 0.05), lower HDL (p < 0.01) and higher triglycerides (p < 0.001). The prevalence of metabolic syndrome, defined as type 2 diabetes or a constellation of blood pressure and lipid changes consistent with metabolic syndrome was 8.7 , 14.9 and 21.9 for limb injury, unilateral amputation and bilateral amputation groups, respectively. Veterans with bilateral lower-limb amputation had a 2.25-increased odds ratio (95 confidence interval 1.19 to 5.05) of type 2 diabetes or blood pressure and lipid changes consistent with metabolic syndrome in comparison to those with limb injury.
Document Details
- Document Type
- Technical Report
- Publication Date
- Sep 01, 2019
- Accession Number
- AD1087755
Entities
People
- Erin Richard
- Jay Walker
- Michael R. Galarneau
- Rehab Al Jawad
- Ted Melcer
- Vibha Bhatnagar
Organizations
- Naval Health Research Center