Gray G C, Smith T C, Kang H K, Knoke J D
Department of Health Sciences and Epidemiology of the Naval Health Research Center, San Diego, CA 92186-5122, USA.
Am J Epidemiol. 2000 Jan 1;151(1):63-71. doi: 10.1093/oxfordjournals.aje.a010123.
A previous epidemiologic study demonstrated no unexplained increase in risk for postwar hospitalization among Gulf War veterans who had remained on active duty. The authors sought to expand this study to include Reserve and separated military personnel. They examined hospitalization data from the Department of Defense, the Department of Veterans Affairs (VA), and the California Office of Statewide Health Planning and Development hospital systems for the years 1991-1994. Since denominator data were not available, the authors compared the proportional morbidity ratios (PMRs) of hospitalization discharge diagnoses (both large categories and specific diagnoses) between Gulf War veterans and other veterans of the same era. There were no indications that Gulf War veterans were suffering increased PMRs for infectious diseases; neoplasms; endocrine diseases; blood diseases; skin conditions; or diseases of the nervous system, circulatory system, or musculoskeletal system. However, these veterans did experience proportionally more hospitalizations for various specific diagnoses, namely, fractures and bone and soft-tissue injuries (Department of Defense and California Office of Statewide Health Planning and Development), various diseases of the respiratory (including asthma) and digestive systems (VA), and diverse symptom diagnoses (VA). While these findings may be influenced by chance or by a number of potential confounders, including health registry participation, they merit further examination using other study designs.
之前的一项流行病学研究表明,仍在服现役的海湾战争退伍军人战后住院风险没有出现无法解释的增加。作者试图扩大这项研究,将后备役军人和退役军人纳入其中。他们研究了1991年至1994年期间来自国防部、退伍军人事务部(VA)以及加利福尼亚州全州卫生规划与发展办公室医院系统的住院数据。由于分母数据不可得,作者比较了海湾战争退伍军人与同一时代其他退伍军人之间住院出院诊断(包括大类诊断和具体诊断)的比例发病比(PMR)。没有迹象表明海湾战争退伍军人在传染病、肿瘤、内分泌疾病、血液疾病、皮肤病或神经系统、循环系统或肌肉骨骼系统疾病方面的PMR有所增加。然而,这些退伍军人在各种具体诊断方面的住院比例确实相对较高,具体包括骨折以及骨骼和软组织损伤(国防部和加利福尼亚州全州卫生规划与发展办公室)、呼吸系统(包括哮喘)和消化系统的各种疾病(退伍军人事务部)以及各种症状诊断(退伍军人事务部)。虽然这些发现可能受到偶然性或包括健康登记参与情况在内的一些潜在混杂因素的影响,但值得使用其他研究设计进行进一步研究。