Deployment-related concussion and long-term health-related quality of life among US military personnel

Qual Life Res. 2023 Jul;32(7):1971-1980. doi: 10.1007/s11136-023-03367-4. Epub 2023 Mar 10.


Purpose: To examine the relationship between deployment-related concussion and long-term health-related quality of life (HRQoL) among injured US military personnel.

Methods: The study sample included 810 service members with deployment-related injuries between 2008 and 2012 who responded to a web-based longitudinal health survey. Participants were categorized into three injury groups: concussion with loss of consciousness (LOC; n = 247), concussion without LOC (n = 317), or no concussion (n = 246). HRQoL was measured using the 36-Item Short Form Health Survey physical and mental component summary (PCS and MCS) scores. Current post-traumatic stress disorder (PTSD) and depression symptoms were examined. Multivariable linear regression models assessed the effects of concussion on PCS and MCS scores, while controlling for covariates.

Results: A lower PCS score was observed in participants with concussion with LOC (B = - 2.65, p = 0.003) compared with those with no history of concussion. Symptoms of PTSD (PCS: B = - 4.84, p < 0.001; MCS: B = - 10.53, p < 0.001) and depression (PCS: B = - 2.85, p < 0.001; MCS: B = - 10.24, p < 0.001) were the strongest statistically significant predictors of lower HRQoL.

Conclusion: Concussion with LOC was significantly associated with lower HRQoL in the physical domain. These findings affirm that concussion management should integrate physical and psychological care to improve long-term HRQoL and warrant a more detailed examination of causal and mediating mechanisms. Future research should continue to incorporate patient-reported outcomes and long-term follow-up of military service members to further define the lifelong impact of deployment-related concussion.

Keywords: Biopsychosocial; Brain injury; Deployment; Health status; Military health.

MeSH terms

  • Brain Concussion*
  • Humans
  • Longitudinal Studies
  • Military Personnel* / psychology
  • Quality of Life / psychology
  • Stress Disorders, Post-Traumatic*