Findings & Publications

Published key findings from the ADVANCE baseline data are summarised below. Full publications and summaries of the key publications can be found further down the page.

Summary of the key findings from the ADVANCE baseline data to date:

  • Cardiovascular risk was found to be slightly increased in the injured cohort compared to the uninjured cohort, but the differences are not big enough to warrant any medical treatment at this stage.
  • The injured non-amputees were found to have greater rates of depression, anxiety and post-traumatic stress disorder (PTSD) compared to those with amputations and the uninjured participants. Participants with amputations and the uninjured participants reported similar rates of mental health issues.
  • The participants with amputations reported greater rates of post-traumatic growth (PTG) compared to the injured non-amputees and the uninjured group. Pain was associated with a higher likelihood of reporting PTG.
  • Lower bone mineral density was seen in the hip of the amputated side of participants with amputation injuries compared to the rest of the cohort. No other significant differences in bone health were seen within the cohort.
  • Heart rate variability (HRV) was found to be lower in the injured group compared to the uninjured group.

Articles

Study protocol for a prospective, longitudinal cohort study investigating the medical and psychosocial outcomes of UK combat casualties from the Afghanistan war: the ADVANCE Study

BMJ Open, Sep 2020

Association between combat-related traumatic injury and cardiovascular risk

Heart, Nov 2021

Mental health outcomes of male UK military personnel deployed to Afghanistan and the role of combat injury: analysis of baseline data from the ADVANCE cohort study

Lancet Psychiatry, Jul 2022

Post-traumatic growth amongst UK armed forces personnel who were deployed to Afghanistan and the role of combat injury, mental health and pain: the ADVANCE cohort study

Psychological Medicine, Aug 2022

Association between non-acute Traumatic Injury (TI) and Heart Rate Variability (HRV) in adults: A systematic review and meta-analysis

PLOS ONE, Jan 2023

The underlying mechanisms by which PTSD symptoms are associated with cardiovascular health in male UK military personnel: The ADVANCE cohort study

Journal of Psychiatric Research, Mar 2023

Relationship between combat-related traumatic injury and ultrashort term heart rate variability in a UK military cohort: findings from the ADVANCE study

BMJ Military Health, Mar 2023

Association Between Combat-Related Traumatic Injury and Skeletal Health: Bone Mineral Density Loss Is Localized and Correlates With Altered Loading in Amputees: the Armed Services Trauma Rehabilitation Outcome (ADVANCE) Study

Journal of Bone and Mineral Research, May 2023

The Relationship between Combat-related Traumatic Amputation and Subclinical Cardiovascular Risk

International Journal of Cardiology, Jul 2023

The Influence of Physical and Mental Health Mediators on the Relationship Between Combat-Related Traumatic Injury and Ultra-Short-Term Heart Rate Variability in a U.K. Military Cohort: A Structural Equation Modeling Approach

Military Medicine, Sep 2023

Reliability of carotid-femoral arterial waveforms for the derivation of ultra-short term heart rate variability in injured British servicemen: An inter-rater reliability study

PLOS One, Sep 2023

Pain after combat injury in male UK military personnel deployed to Afghanistan

British Journal of Anaesthesia, Mar 2024

The underlying mechanisms by which Post-Traumatic Growth is associated with cardiovascular health in male UK military personnel: The ADVANCE cohort study

Journal of Health Psychology, Apr 2024

Level of perceived social support, and associated factors, in combat-exposed (ex-)military personnel: a systematic review and meta-analysis

Soc Psychiatry Epidemiol, May 2024

Upper Limb Function in People With Upper and Lower Limb Loss 8 Years Postinjury: The Armed Services Trauma Outcome Study (ADVANCE) Cohort Study

Physical Therapy, Jul 2024

Validity of Ultra-Short-Term Heart Rate Variability Derived from Femoral Arterial Pulse Waveform in a British Military Cohort

Appl. Psychophysiol Biofeedback, Jul 2024

Suicidal ideation in male UK military personnel who sustained a physical combat injury in Afghanistan and the mediating role of leaving service: The ADVANCE cohort study

International Journal of Social Psychiatry, Jul 2024

Association of serum biomarkers with radiographic knee osteoarthritis, knee pain and function in a young, male, trauma-exposed population – Findings from the ADVANCE Study

Osteoarthritis and Cartilage, Aug 2024

Developing an exercise intervention to minimise hip bone mineral density loss following traumatic lower limb amputation: a Delphi study

British Journal of Sports Medicine, Sep 2024

The association between perceived social support and mental health in injured and uninjured military personnel

Journal of Psychiatric Research, Nov 2024