Combat Blast Injuries: Injury Severity and Posttraumatic Stress Disorder Interaction on Career Outcomes in Male Servicemembers

The purpose of this study was to describe career performance outcomes after combat blast injury and to examine the relationship between the injury severity and type of military discharge. A retrospective cohort study of 4,255 male servicemembers injured in a combat blast as a part of Operation Iraqi Freedom was completed. In the total sample, 37.8% experienced a normal discharge and 8.3% had an early discharge. Of the 2,229 members who had a discharge code, 29.8% experienced a disability discharge. Both early attrition and disability discharge proportions were higher in those with posttraumatic stress disorder (PTSD) than in those without PTSD. There was a significant interaction between PTSD and injury severity in the discharge disability outcome. In those without PTSD, there was a dose-response relationship between injury severity and disability discharge. In those with PTSD, injury severity predicted disability discharge. The relationship between injury severity and disability discharge was less striking in servicemembers with PTSD than without PTSD. The effect of PTSD and injury severity on career performance outcomes after blast injuries should be factored into outcome planning. Published in the Journal of Rehabilitation Research and Development, v50 n1 p7-16, 2013. Prepared in collaboration with the Department of Defense HIV/AIDS Prevention Program, Naval Health Research Center, San Diego, CA, and in cooperation with the Graduate School of Public Health and School of Social Work, San Diego State University, San Diego, CA, the Graduate School of Public Health and School of Social Work, San Diego State University, San Diego, CA, and the Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, CA.