Mortality and postcombat disorders: U.K. veterans of the Boer War and World War I

Abstract

This study seeks to investigate the mortality rates of U.K. servicemen with postcombat syndromes following the Boer War and World War I. Random samples of veterans awarded war pensions for either disordered action of the heart (DAH) or neurasthenia/shellshock were compared with gunshot wounded ex-servicemen as controls. The destruction of pension records has led to reliance on groups of the longest lived veterans, which diminishes their representative qualities. Study groups were matched by rank and level of disability. With the exception of DAH cases in World War I, no statistically significant difference in mortality rates was found using Cox proportional hazards. The same DAH subjects were then compared with gunshot wound controls whose disability had been assessed 20% higher, and no statistically significant difference was seen. The reason why World War I veterans with DAH had a reduced life expectancy remains unclear, although it is possible that physician bias in assessment and the termination by the Ministry of Pensions of awards granted to healthy cases may have been factors. Postcombat disorders suffered by U.K. servicemen after the Boer War and World War I were not generally associated with an increased mortality.