Transition outcomes of Armed Forces personnel with battlefield injuries: a summary of the literature

What was the purpose of this review?

The purpose of this review was to collate and examine the existing literature on the transition outcomes of military personnel who have sustained physical battlefield injuries. This was done as part of the ADVANCE-INVEST study.


The ADVANCE-INVEST (Injured Veterans’ Experiences of Transition) study is a subsidiary of the ADVANCE study, a long-term project which investigates the transitional experiences and outcomes of battlefield casualties who have transitioned from military to civilian life, comparing them with other transitioning personnel.

Which outcomes did we look at?

This review explored return to duty rates (RTD), employment outcomes and wellbeing outcomes related to transition, such as independence and social functioning and well-being. The review focused specifically on the outcomes of battlefield casualties as opposed to those (ex-) Service personnel who were wounded, injured, or became sick as a result of non-operational events (including deployment related activities which were not combat-related).

How many articles were identified?

Articles were systematically identified, but only a small number of papers (a total of 13) fulfilled requirements for inclusion. In a large part this was because studies often focus on either health conditions or deployment periods, rather than specifically identifying personnel with battlefield injuries.

What did we find?

We found that RTD rates were lower for those who underwent amputation subsequent to battlefield injury. Similarly, employment rates for those who left the Armed Forces were generally high but lower for those with major amputations and/or additional physical health needs. Well-being measures were largely similar to uninjured comparator groups, with some evidence that physical well-being is unaffected but mental well-being suffers as a result of battlefield injury. However, the evidence for this is somewhat sparse.

What did we conclude?

Overall, evidence on this topic was limited. However, studies currently underway, in particular the ADVANCE Study, will be able to provide more complete evidence on this topic in a UK context.

Who conducted this research?

The ADVANCE-INVEST team is led by Professor Nicola Fear. She is Professor of Epidemiology and Director of the King’s Centre for Military Health Research, alongside Sir Simon Wessely. Dr Howard Burdett, a Post-Doctoral Researcher and Anna Verey, a Research Assistant, make up the rest of the ADVANCE-INVEST team.

If you would like to find out more, you can read the full review article here.

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