Veterans more likely to lose limbs to disease than warfare

The number of Scottish veterans who sustain an amputation through disease is far greater than the number who have lost limbs in conflict, according to new research.

The study—from the University of Glasgow and published in BMJ Military Health—found that in the long term, the most common cause of limb loss in veterans is diabetes and peripheral arterial disease (blockage of arteries).

The research also found that, despite veterans having more risk factors such as smoking, their rate of disease-related amputation is no different from people in the wider community.

During the recent conflicts in Iraq and Afghanistan, more than 300 military personnel sustained injuries resulting in amputation but the number of UK veterans who lose limbs to disease has been largely unknown.

Lead researcher Dr. Beverly Bergman, Honorary Senior Research Fellow and leader of the Scottish Veterans Health Research Group at the University of Glasgow—who was recently awarded an OBE for her work on veterans—said: "Losing a limb is one of the most devastating consequences of combat, but it is important that we do not forget the much larger number of both veterans and non-veterans who are affected in exactly the same way, but through disease.

"People can reduce their risk by maintaining a healthy weight and avoiding smoking; but, in the meantime, it's important that we make plans to offer support for aging veterans who have lost limbs due to disease, so they are given the same care as that afforded to the victims of conflict, who often benefit from a higher profile and greater perceived public support."

The retrospective cohort study, using data from the Trends in Scottish Veterans' Health Study, looked at 78,000 veterans and 253,000 non-veterans in Scotland born between 1945 and 1995, matched for age, sex and area of residence. The study used survival analysis to examine the risk of amputation in veterans compared with non-veterans, and explored associations with antecedent disease.

Peripheral arterial disease was recorded in two-thirds of both veteran and non-veteran amputees, and type 2 diabetes in 41% of veterans and 33% of non-veterans, with a dual diagnosis in 32% of veterans and 26% of non-veterans. Trauma was an infrequent cause of amputation.

The study, "Post-service lower limb amputation in Scottish military veterans," is published in BMJ Military Health.