Retrospective study of cardiovascular disease risk factors among a cohort of combat veterans with lower limb amputation
Journal Article - Open Access,01 Jan 2014,30 Nov 2014
NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA SAN DIEGO United States
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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.
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