Evacuation Time and Tourniquet Use as Risk Factors for PTSD in Combat-Related Amputation

N/ANot Yet RecruitingNCT07502313

Charitable Organisation Charitable Fund Superhumans (Co Cf Superhumans)300 enrolled

Overview

This study aims to evaluate the relationship between evacuation time, tourniquet use, and the development of post-traumatic stress disorder (PTSD) in patients with combat-related amputations. In the context of modern warfare, prolonged evacuation times and extended tourniquet application may contribute not only to physical injury but also to psychological trauma. The study will prospectively follow patients over 18 months to identify key predictors of PTSD and to assess their interaction.

Combat-related amputations are frequently associated with prolonged evacuation times and the use of hemostatic tourniquets. While these factors are critical for survival, their potential contribution to long-term psychological outcomes remains insufficiently studied. This prospective longitudinal study will investigate how evacuation delays and tourniquet duration influence the development of PTSD symptoms in Ukrainian veterans with limb amputations. The study will also evaluate the interaction between these factors and their cumulative psychological impact. Participants will be followed for 18 months using validated PTSD screening tools, including the PCL-5 questionnaire, combined with retrospective analysis of medical records.

Study Type

OBSERVATIONAL

Enrollment

300

Conditions

Amputation PTSD Combat Posttraumatic Stess Disorder Combat Trauma

Eligibility

Sex: ALLMin age: 18 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Ukrainian veterans with combat-related injury (post-February 2022) * Single limb amputation * Admission to rehabilitation within 2-4 months post-injury * Age ≥18 years * Ability to provide informed consent Exclusion Criteria: * Prior PTSD diagnosis before current injury * Multiple amputations * Rehabilitation duration \>3 months * Return to active military duty before follow-up completion

Outcomes

Primary Outcomes

PTSD severity measured by PCL-5 score

Severity of post-traumatic stress disorder (PTSD) symptoms will be assessed using the PTSD Checklist for DSM-5 (PCL-5), a validated 20-item self-report questionnaire. Each item is scored on a scale from 0 (not at all) to 4 (extremely), with a total score range of 0 to 80, where higher scores indicate greater symptom severity. The primary outcome will be the total PCL-5 score measured longitudinally to evaluate changes in PTSD symptom severity over time and its association with evacuation time and duration of tourniquet use.

Time frame: 18 months (baseline, 2, 6, 12, and 18 months follow-up)

Secondary Outcomes

Change in PTSD Severity Over Time

Change in PTSD symptom severity measured as the difference in total PCL-5 score between baseline and follow-up assessments. This outcome will evaluate the trajectory of PTSD symptoms over time.

Time frame: Baseline to 18 months