Physical Injury, War Injury
Conditions
Brief summary
Beyond short-term multidisciplinary care, the French Armed Forces Health Service provides medical and surgical care, followed by medical and social care and long-term support for the wounded, especially when they have suffered multiple injuries during operations and are severely disabled. This involves primary phases of rehabilitation to limit the after-effects, preserve the functional prognosis and increase the autonomy of the injured person; secondary medical and social phases of rehabilitation and reintegration to restore the injured person's place in society. The reconstruction stages are therefore essential. However, little data is available on the evolution of these patients' general health. A similar follow-up cohort was set up by the British Army to monitor physical injuries during the conflict in Afghanistan. The results suggest the possibility of long-term cardiovascular and neoplastic complications in this population. Furthermore, there is no data available on the evolution of the health status of war wounded in France. A retrospective study is currently underway, TRAUM-IMPACT RETRO, with the aim of assessing the consequences of 10 years of operational engagements from 2013 to 2023. This study should enable the medical French army service to clarify the topography of injuries and the medical and social outcomes of casualties treated at the Percy National Military Institute of Surgery (HNIA Percy) during this period. Initially, a pilot study followed by a cohort study will enable the investigators to standardise the medical follow-up of war casualties and determine their medical and social outcomes. The population studied in this clinical trial corresponds to all military personnel repatriated and treated at the Percy National Military Hospital for a war injury defined as follows: "Any physical injury of a certain degree of severity directly related to the presence of the enemy, i.e. in combat or indirectly through effective participation in war operations, preparatory to or consequential to combat. " The investigators hypothesise that severely disabled wounded soldiers are at risk of specific complications leading to excess morbidity and disability, complications associated with ageing, and a risk of social and professional isolation. As a result, the participants require lifelong monitoring to prevent, detect and manage these complications, thereby ensuring that the nation gives its wounded children the recognition the participants deserve.
Interventions
OTHERbiological and radiological examinations
The TRAUM-IMPACT study designed to assess the feasibility of establishing a long-term cohort study to monitor war casualties and will be carried out in parallel with the usual care provided.
Sponsors
Direction Centrale du Service de Santé des Armées
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Intervention model description
Cohort
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * French military patient * Patient wounded in action * Patient repatriated and treated at the Percy National Military Hospital for a physical war injury sustained between 2020 and 2025 * Life expectancy \> 1 year * Patient conscious and oriented at the time of inclusion * Patient with health insurance
Exclusion criteria
* Isolated psychological injury * Physical injury not related to war * Patient unable to give free consent, under guardianship or curatorship * Refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The primary outcome is the feasibility of a standardized multidisciplinary follow-up strategy, assessed by patient recruitment rate, retention rate during follow-up, completion | 2 years | Health event reported during visits over the course of the study and type of injury at inclusion (multiple trauma, limb trauma, head trauma). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Longitudinal evolution of quality of life according to type of injury | 2 years | Short-Forme (SF) 36 quality of life score |
| Longitudinal changes in gait performance | 2 yaers | Gait performance will be evaluated using both clinical and instrumented assessments, including walking speed, walking perimeter, Timed Up and Go (TUG) test, wearable sensor-based gait analysis (spatiotemporal gait parameters), static postural assessment, and balance evaluation. These measures will be used to quantify changes in mobility, stability, and functional recovery throughout follow-up. |
| Define predictive factors for the occurrence of a new diagnosis or new treatment (psychiatric illness, chronic illness, cardiovascular disease, neoplasia, or any relevant medical event). | 2 yaers | Search for the occurrence of a new diagnosis or new treatment (psychiatric illness, chronic illness, cardiovascular disease, neoplasia, or any relevant medical event) and predictive factors. |
| Level of generic pain | 2 years | Generic pain questionnaire (QDSA) |
| Level of anxiety and depression | 2 years | HAD anxiety/depression scale |
| Sleep quality | 2 years | Sleep disorder screening (Epworth score) |
| Level of physical inactivity | 2 years | Specific questionnaire on returning to sport/sedentary lifestyle |
| Addictive behaviours | 2 years | Addictive behaviour screening questionnaire (alcohol, tobacco, drugs) |
| Incidence of Post-Traumatic Stress Disorder | 2 years | PCLS-5 questionnaire |
Contacts
CONTACTCaroline DOUTRELON, Chief Medical Officer
Outcome results
None listed