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

Evacuation Time and Tourniquet Use as Risk Factors for PTSD in Combat-Related Amputation: A Prospective Cohort Study

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.

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