Relationship between combat-related traumatic injury and ultrashort term heart rate variability in a UK military cohort: findings from the ADVANCE study
Authors: Maqsood, R., Schofield, S., Bennett, A.N., Bull, A.M.J., Fear, N.T., Cullinan, P., Khattab, A. and Boos, C.J.
Journal: BMJ Military Health
eISSN: 2633-3775
ISSN: 2633-3767
DOI: 10.1136/military-2022-002316
Abstract:Introduction: Combat-related traumatic injury (CRTI) has been linked to an increased cardiovascular disease (CVD) risk. The long-term impact of CRTI on heart rate variability (HRV) - a robust CVD risk marker - has not been explored. This study investigated the relationship between CRTI, the mechanism of injury and injury severity on HRV. Methods: This was an analysis of baseline data from the ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE) prospective cohort study. The sample consisted of UK servicemen with CRTI sustained during deployment (Afghanistan, 2003-2014) and an uninjured comparison group who were frequency matched to the injured group based on age, rank, deployment period and role in theatre. Root mean square of successive differences (RMSSD) was measured as a measure of ultrashort term HRV via <16 s continuous recording of the femoral arterial pulse waveform signal (Vicorder). Other measures included injury severity (New Injury Severity Scores (NISS)) and injury mechanism. Results: Overall, 862 participants aged 33.9±5.4 years were included, of whom 428 (49.6%) were injured and 434 (50.3%) were uninjured. The mean time from injury/deployment to assessment was 7.91±2.05 years. The median (IQR) NISS for those injured was 12 (6-27) with blast being the predominant injury mechanism (76.8%). The median (IQR) RMSSD was significantly lower in the injured versus the uninjured (39.47 ms (27.77-59.77) vs 46.22 ms (31.14-67.84), p<0.001). Using multiple linear regression (adjusting for age, rank, ethnicity and time from injury), geometric mean ratio (GMR) was reported. CRTI was associated with a 13% lower RMSSD versus the uninjured group (GMR 0.87, 95% CI 0.80-0.94, p<0.001). A higher injury severity (NISS ≥25) (GMR 0.78, 95% CI 0.69-0.89, p<0.001) and blast injury (GMR 0.86, 95% CI 0.79-0.93, p<0.001) were also independently associated with lower RMSSD. Conclusion: These results suggest an inverse association between CRTI, higher severity and blast injury with HRV. Longitudinal studies and examination of potential mediating factors in this CRTI-HRV relationship are needed.
https://eprints.bournemouth.ac.uk/38401/
Source: Scopus
Relationship between combat-related traumatic injury and ultrashort term heart rate variability in a UK military cohort: findings from the ADVANCE study.
Authors: Maqsood, R., Schofield, S., Bennett, A.N., Bull, A.M., Fear, N.T., Cullinan, P., Khattab, A., Boos, C.J. and ADVANCE study
Journal: BMJ Mil Health
Volume: 170
Issue: e2
Pages: e122-e127
eISSN: 2633-3775
DOI: 10.1136/military-2022-002316
Abstract:INTRODUCTION: Combat-related traumatic injury (CRTI) has been linked to an increased cardiovascular disease (CVD) risk. The long-term impact of CRTI on heart rate variability (HRV)-a robust CVD risk marker-has not been explored. This study investigated the relationship between CRTI, the mechanism of injury and injury severity on HRV. METHODS: This was an analysis of baseline data from the ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE) prospective cohort study. The sample consisted of UK servicemen with CRTI sustained during deployment (Afghanistan, 2003-2014) and an uninjured comparison group who were frequency matched to the injured group based on age, rank, deployment period and role in theatre. Root mean square of successive differences (RMSSD) was measured as a measure of ultrashort term HRV via <16 s continuous recording of the femoral arterial pulse waveform signal (Vicorder). Other measures included injury severity (New Injury Severity Scores (NISS)) and injury mechanism. RESULTS: Overall, 862 participants aged 33.9±5.4 years were included, of whom 428 (49.6%) were injured and 434 (50.3%) were uninjured. The mean time from injury/deployment to assessment was 7.91±2.05 years. The median (IQR) NISS for those injured was 12 (6-27) with blast being the predominant injury mechanism (76.8%). The median (IQR) RMSSD was significantly lower in the injured versus the uninjured (39.47 ms (27.77-59.77) vs 46.22 ms (31.14-67.84), p<0.001). Using multiple linear regression (adjusting for age, rank, ethnicity and time from injury), geometric mean ratio (GMR) was reported. CRTI was associated with a 13% lower RMSSD versus the uninjured group (GMR 0.87, 95% CI 0.80-0.94, p<0.001). A higher injury severity (NISS ≥25) (GMR 0.78, 95% CI 0.69-0.89, p<0.001) and blast injury (GMR 0.86, 95% CI 0.79-0.93, p<0.001) were also independently associated with lower RMSSD. CONCLUSION: These results suggest an inverse association between CRTI, higher severity and blast injury with HRV. Longitudinal studies and examination of potential mediating factors in this CRTI-HRV relationship are needed.
https://eprints.bournemouth.ac.uk/38401/
Source: PubMed
Relationship between combat-related traumatic injury and ultrashort term heart rate variability in a UK military cohort: findings from the ADVANCE study
Authors: Maqsood, R., Schofield, S., Bennett, A.N., Bull, A.M.J., Fear, N.T., Cullinan, P., Khattab, A. and Boos, C.J.
Journal: BMJ MILITARY HEALTH
eISSN: 2633-3775
ISSN: 2633-3767
DOI: 10.1136/military-2022-002316
https://eprints.bournemouth.ac.uk/38401/
Source: Web of Science (Lite)
Relationship between combat-related traumatic injury and ultrashort term heart rate variability in a UK military cohort: findings from the ADVANCE study.
Authors: Maqsood, R., Schofield, S., Bennett, A.N., Bull, A.M., Fear, N.T., Cullinan, P., Khattab, A. and Boos, C.J.
Journal: BMJ Mil Health
Volume: 0
Pages: 1-6
Publisher: BMJ
DOI: 10.1136/military-2022-002316
Abstract:Abstract Introduction Combat-related traumatic injury (CRTI) has been linked to an increased cardiovascular disease (CVD) risk. The long-term impact of CRTI on heart rate variability (HRV)—a robust CVD risk marker—has not been explored. This study investigated the relationship between CRTI, the mechanism of injury and injury severity on HRV.
Methods This was an analysis of baseline data from the ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE) prospective cohort study. The sample consisted of UK servicemen with CRTI sustained during deployment (Afghanistan, 2003–2014) and an uninjured comparison group who were frequency matched to the injured group based on age, rank, deployment period and role in theatre. Root mean square of successive differences (RMSSD) was measured as a measure of ultrashort term HRV via <16 s continuous recording of the femoral arterial pulse waveform signal (Vicorder). Other measures included injury severity (New Injury Severity Scores (NISS)) and injury mechanism.
Results Overall, 862 participants aged 33.9±5.4 years were included, of whom 428 (49.6%) were injured and 434 (50.3%) were uninjured. The mean time from injury/deployment to assessment was 7.91±2.05 years. The median (IQR) NISS for those injured was 12 (6–27) with blast being the predominant injury mechanism (76.8%). The median (IQR) RMSSD was significantly lower in the injured versus the uninjured (39.47 ms (27.77–59.77) vs 46.22 ms (31.14–67.84), p<0.001). Using multiple linear regression (adjusting for age, rank, ethnicity and time from injury), geometric mean ratio (GMR) was reported. CRTI was associated with a 13% lower RMSSD versus the uninjured group (GMR 0.87, 95% CI 0.80–0.94, p<0.001). A higher injury severity (NISS ≥25) (GMR 0.78, 95% CI 0.69–0.89, p<0.001) and blast injury (GMR 0.86, 95% CI 0.79–0.93, p<0.001) were also independently associated with lower RMSSD.
Conclusion These results suggest an inverse association between CRTI, higher severity and blast injury with HRV. Longitudinal studies and examination of potential mediating factors in this CRTI-HRV relationship are needed.
https://eprints.bournemouth.ac.uk/38401/
http://creativecommons.org/licenses/by-nc/4.0/
Source: Manual
Relationship between combat-related traumatic injury and ultrashort term heart rate variability in a UK military cohort: findings from the ADVANCE study
Authors: Maqsood, R., Schofield, S., Bennett, A., Bull, A., Fear, N., Cullinan, P., Khattab, A. and Boos, C.
Journal: BMJ Military Health
https://eprints.bournemouth.ac.uk/38401/
Source: Manual
Relationship between combat-related traumatic injury and ultrashort term heart rate variability in a UK military cohort: findings from the ADVANCE study.
Authors: Maqsood, R., Schofield, S., Bennett, A.N., Bull, A.M., Fear, N.T., Cullinan, P., Khattab, A., Boos, C.J. and ADVANCE study
Journal: BMJ military health
Volume: 170
Issue: e2
Pages: e122-e127
eISSN: 2633-3775
ISSN: 2633-3767
DOI: 10.1136/military-2022-002316
Abstract:Introduction
Combat-related traumatic injury (CRTI) has been linked to an increased cardiovascular disease (CVD) risk. The long-term impact of CRTI on heart rate variability (HRV)-a robust CVD risk marker-has not been explored. This study investigated the relationship between CRTI, the mechanism of injury and injury severity on HRV.Methods
This was an analysis of baseline data from the ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE) prospective cohort study. The sample consisted of UK servicemen with CRTI sustained during deployment (Afghanistan, 2003-2014) and an uninjured comparison group who were frequency matched to the injured group based on age, rank, deployment period and role in theatre. Root mean square of successive differences (RMSSD) was measured as a measure of ultrashort term HRV via <16 s continuous recording of the femoral arterial pulse waveform signal (Vicorder). Other measures included injury severity (New Injury Severity Scores (NISS)) and injury mechanism.Results
Overall, 862 participants aged 33.9±5.4 years were included, of whom 428 (49.6%) were injured and 434 (50.3%) were uninjured. The mean time from injury/deployment to assessment was 7.91±2.05 years. The median (IQR) NISS for those injured was 12 (6-27) with blast being the predominant injury mechanism (76.8%). The median (IQR) RMSSD was significantly lower in the injured versus the uninjured (39.47 ms (27.77-59.77) vs 46.22 ms (31.14-67.84), p<0.001). Using multiple linear regression (adjusting for age, rank, ethnicity and time from injury), geometric mean ratio (GMR) was reported. CRTI was associated with a 13% lower RMSSD versus the uninjured group (GMR 0.87, 95% CI 0.80-0.94, p<0.001). A higher injury severity (NISS ≥25) (GMR 0.78, 95% CI 0.69-0.89, p<0.001) and blast injury (GMR 0.86, 95% CI 0.79-0.93, p<0.001) were also independently associated with lower RMSSD.Conclusion
These results suggest an inverse association between CRTI, higher severity and blast injury with HRV. Longitudinal studies and examination of potential mediating factors in this CRTI-HRV relationship are needed.https://eprints.bournemouth.ac.uk/38401/
Source: Europe PubMed Central
Relationship between combat-related traumatic injury and ultrashort term heart rate variability in a UK military cohort: findings from the ADVANCE study
Authors: Maqsood, R., Schofield, S., Bennett, A.N., Bull, A.M.J., Fear, N.T., Cullinan, P., Khattab, A.D. and Boos, C.J.
Journal: BMJ Military Health
Issue: Mar
Pages: 1-6
Abstract:Introduction Combat-related traumatic injury (CRTI) has been linked to an increased cardiovascular disease (CVD) risk. The long-term impact of CRTI on heart rate variability (HRV)—a robust CVD risk marker—has not been explored. This study investigated the relationship between CRTI, the mechanism of injury and injury severity on HRV.
Methods This was an analysis of baseline data from the ArmeD SerVices TrAuma and RehabilitatioN OutComE (ADVANCE) prospective cohort study. The sample consisted of UK servicemen with CRTI sustained during deployment (Afghanistan, 2003–2014) and an uninjured comparison group who were frequency matched to the injured group based on age, rank, deployment period and role in theatre. Root mean square of successive differences (RMSSD) was measured as a measure of ultrashort term HRV via <16 s continuous recording of the femoral arterial pulse waveform signal (Vicorder). Other measures included injury severity (New Injury Severity Scores (NISS)) and injury mechanism.
Results Overall, 862 participants aged 33.9±5.4 years were included, of whom 428 (49.6%) were injured and 434 (50.3%) were uninjured. The mean time from injury/ deployment to assessment was 7.91±2.05 years. The median (IQR) NISS for those injured was 12 (6–27) with blast being the predominant injury mechanism (76.8%).
The median (IQR) RMSSD was significantly lower in the injured versus the uninjured (39.47 ms (27.77–59.77) vs 46.22 ms (31.14–67.84), p<0.001). Using multiple linear regression (adjusting for age, rank, ethnicity and time from injury), geometric mean ratio (GMR) was reported. CRTI was associated with a 13% lower RMSSD versus the uninjured group (GMR 0.87, 95% CI 0.80–0.94, p<0.001).
A higher injury severity (NISS ≥25) (GMR 0.78, 95% CI 0.69–0.89, p<0.001) and blast injury (GMR 0.86, 95% CI 0.79–0.93, p<0.001) were also independently associated with lower RMSSD.
Conclusion These results suggest an inverse association between CRTI, higher severity and blast injury with HRV.
Longitudinal studies and examination of potential mediating factors in this CRTI-HRV relationship are needed.
https://eprints.bournemouth.ac.uk/38401/
Source: BURO EPrints