FORT SAM HOUSTON, TX—The diagnosis and coordination of care for veterans with genitourinary injury can be improved, a new study found.
The report in Military Medicine pointed out that, in recent U.S. military engagements, unprecedented numbers of servicemembers have survived with GU injury, but few studies have focused on outcomes of these injuries.1
The U.S. Army Institute of Surgical Research-led study focused on Outcomes of combat-related GU injury in wounded U.S. male veterans of Operations Enduring/Iraqi Freedom and New Dawn receiving care at the VHA.
The researchers linked DoD Trauma Registry data for male troops injured in theater with VHA electronic health records for veterans who received VHA care at least once from October 2001 through September 2011. Used to identify GU injuries, severity and outcomes were Abbreviated Injury Scale scores and International Classification of Diseases-9th Revision-Clinical Modification codes, and that cohort was compared to veterans without GU injury.
Out of 12,923 injured veterans found in both databases, 4.6% had a GU injury diagnosis in the DoDTR, and 3% had a GU injury diagnosis in VHA EHRs. About one-third of the GU injuries were considered severe.
Results indicated that the prevalence of both urinary symptoms (6.3% vs. 3.1%; p < 0.0001) and sexual dysfunction (13.5% vs. 7.1%; p < 0.0001) was higher among those with vs. without GU injury. Researchers also determined that traumatic brain injury prevalence was also higher (48.0 % vs. 40.0%; p < 0.0001), although post-traumatic stress disorder prevalence was similar between the two groups (51.6% vs. 50.6%).
“We identified an opportunity to improve the diagnosis and coordination of care for veterans with GU injury,” study authors concluded. “Routine screening and better documentation upon transfer from DoD to VHA care should be implemented to alert multi-specialty care teams to provide care for the urinary, sexual, fertility, and psychological health problems of these patients.”
1. Nnamani NS, Pugh MJ, Amuan ME, Eapen BC, Hudak SJ, Liss MA, Orman JA. Outcomes of Genitourinary Injury in U.S. Iraq and Afghanistan War Veterans Receiving Care from the Veterans Health Administration. Mil Med. 2018 Aug 14. doi: 10.1093/milmed/usy196. [Epub ahead of print] PubMed PMID: 30124961.