Quality of Life Research

, Volume 27, Issue 5, pp 1393–1402 | Cite as

Health-related quality of life among US military personnel injured in combat: findings from the Wounded Warrior Recovery Project

  • Susan I. Woodruff
  • Michael R. Galarneau
  • Cameron T. McCabe
  • Daniel I. Sack
  • Mary C. Clouser



Little is known about the long-term, health-related quality of life (HRQOL) of those wounded in combat during Operations Enduring Freedom, Iraqi Freedom, and New Dawn. The present study described the overall HRQOL for a large group of US service members experiencing mild-to-severe combat-related injuries, and assessed the unique contribution of demographics, service- and injury-related characteristics, and mental health factors on long-term HRQOL.


The Wounded Warrior Recovery Project examines patient-reported outcomes in a cohort of US military personnel wounded in combat. Participants were identified from the Expeditionary Medical Encounter Database, a US Navy-maintained deployment health database, and invited to complete a web-based survey. At the time of this study, 3245 service members consented and completed the survey. Hierarchical linear regression analyses were conducted to assess the unique contribution of each set of antecedents on HRQOL scores.


HRQOL was uniquely associated with a number of demographics, and service- and injury-related characteristics. Nevertheless, screening positive for posttraumatic stress disorder (B = − .09; P < .001), depression (B = − .10; P < .001), or both as a set (B = − .19; P < .001) were the strongest predictors of lower long-term HRQOL.


Postinjury HRQOL among service members wounded in combat was associated with service and injury experience, and demographic factors, but was most strongly linked with current mental health status. These findings underscore the significance of mental health issues long after injury. Further, findings reinforce that long-term mental health screening, services, and treatment are needed for those injured in combat.


Health-related quality of life Mental health Injury Military 



We gratefully acknowledge LCDR Andrew MacGregor for assisting with study concept and design, Judy Dye for clinical support, and Amber Dougherty for critically reviewing and editing the manuscript.


I am an employee of the U.S. Government. This work was prepared as part of my official duties. Title 17, U.S.C. §105 provides the “Copyright protection under this title is not available for any work of the United States Government.” Title 17, USC, §101 defines a U.S. Government work as work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties. Report No. 17-XX was supported by Bureau of Medicine and Surgery, under the Wounded, Ill, and Injured Psychological Health and Traumatic Brain Injury Program, under work unit No. 60808. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of the Army, Department of the Air Force, Department of Veterans Affairs, Department of Defense, or the U.S. Government. This article is approved for public release and distribution is unlimited. This research has been conducted in compliance with all applicable federal regulations governing the protection of human subjects in research (Protocol NHRC.2009.0014).


Report No. 17-XX was supported by Bureau of Medicine and Surgery, under the Wounded, Ill, and Injured Psychological Health and Traumatic Brain Injury Program, under work unit No. 60808.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Susan I. Woodruff
    • 1
  • Michael R. Galarneau
    • 2
  • Cameron T. McCabe
    • 1
  • Daniel I. Sack
    • 3
  • Mary C. Clouser
    • 1
  1. 1.Leidos Inc.San DiegoUSA
  2. 2.Medical Modeling, Simulation, and Mission SupportNaval Health Research CenterSan DiegoUSA
  3. 3.AxiomSan DiegoUSA

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