Forman-Hoffman Valerie L, Peloso Paul M, Black Donald W, Woolson Robert F, Letuchy Elena M, Doebbeling Bradley N
Center for Research in the Implementation of Innovative Strategies in Practice, Iowa City Veteran's Affairs Medical Center, Iowa City, Iowa 52242, USA.
J Pain. 2007 Dec;8(12):954-61. doi: 10.1016/j.jpain.2007.07.003. Epub 2007 Aug 20.
Our study sought to 1) determine if deployment status is associated with chronic widespread pain (CWP), and 2) evaluate whether veterans with CWP have greater psychiatric comorbidity, higher health care utilization, and poorer health status than veterans without CWP. Five years after the conclusion of the first Gulf War (August 1990 to June 1991), we conducted a cross-sectional study of veterans who listed Iowa as the home of record using a stratified sampling design to determine their health status. We compared the prevalence of CWP between deployed and nondeployed veterans. Logistic and multiple linear regression models were constructed to test whether CWP was associated with comorbidities and health-related outcomes of interest. Five hundred ninety of 3695 veterans interviewed (16%) had CWP. Gulf deployment was associated with higher prevalence of CWP than deployment elsewhere (OR = 2.03, 95%CI = 1.60-2.58), after adjustment. Both deployed and nondeployed veterans with CWP reported more health care utilization and comorbidities and lower health-related quality of life scores than veterans without CWP. Deployed veterans were more likely to have CWP than nondeployed veterans, and CWP was associated with poor health outcomes. Military and medical personnel should be aware that efforts to prevent, identify, and treat CWP in veterans returning from the current war may be needed.
This article indicates that deployed veterans may have an increased risk for development of CWP, which is associated with greater healthcare utilization and comorbidity and lower quality of life. The risk of poor health outcomes suggests that veterans returning from the present conflict should be screened for CWP on their return.
我们的研究旨在:1)确定部署状态是否与慢性广泛性疼痛(CWP)相关;2)评估患有CWP的退伍军人与未患CWP的退伍军人相比,是否有更多的精神疾病共病、更高的医疗保健利用率和更差的健康状况。在第一次海湾战争结束五年后(1990年8月至1991年6月),我们对将爱荷华州列为记录所在地的退伍军人进行了一项横断面研究,采用分层抽样设计来确定他们的健康状况。我们比较了已部署和未部署退伍军人中CWP的患病率。构建了逻辑回归模型和多元线性回归模型,以检验CWP是否与感兴趣的共病和健康相关结果相关。在接受采访的3695名退伍军人中,590人(16%)患有CWP。经过调整后,海湾地区部署与CWP的患病率高于其他地区部署相关(OR = 2.03,95%CI = 1.60 - 2.58)。与未患CWP的退伍军人相比,患有CWP的已部署和未部署退伍军人都报告了更多的医疗保健利用率和共病情况,以及更低的健康相关生活质量得分。已部署退伍军人比未部署退伍军人更有可能患有CWP,且CWP与不良健康结果相关。军事和医务人员应意识到,可能需要努力预防、识别和治疗从当前战争返回的退伍军人中的CWP。
本文表明,已部署的退伍军人患CWP的风险可能增加,这与更高的医疗保健利用率、共病情况以及更低的生活质量相关。不良健康结果的风险表明,从当前冲突返回的退伍军人在返回时应接受CWP筛查。