Effects of Re-injury on Military Discharge from the US Army

Purpose: An injury is one of the major risk factors predicting another injury. Such re-injuries may be important among military personnel because of time lost from duty, potential disability, and health care costs. We investigated the role of re-injury on physical disability discharge from the US Army by following a cohort of soldiers with a hospitalized injury early in their military career.

Methods: The retrospective cohort was built with data from the Total Army Injury and Health Outcomes Database and included 5,678 active-duty Army personnel with an injury hospitalization between 1992 and 2002. These soldiers were followed to re-injury hospitalizations that included both musculoskeletal conditions and acute traumatic injuries. Cox proportional hazards regression was used to estimate the risk for discharge controlling for other risk factors.

Results: Three-hundred twenty-nine soldiers (6%) had a re-injury hospitalization during the follow-up period. Nine-hundred seventy-seven soldiers (17%) were discharged from the Army due to physical disabilities during the follow-up period. Re-injury was significantly associated with a physical disability discharge controlling for education, marital status, enlistment status, and whether the first injury occurred while on-duty (HR=1.34, 95%CI=1.04-1.72). Those with a re-injury were discharged significantly sooner than those without a re-injury (log rank test, p<0.0001).

Conclusions: Re-injury was found to be a risk factor for premature military discharge and those with a re-injury were discharged significantly sooner than those without a re-injury. Re-injury has potentially long-lasting and serious effects on military disability and discharge.