Defense and Veterans Brain Injury Center, Walter Reed Army Medical Center, Washington, DC, USA.
NeuroRehabilitation. 2010;26(3):183-9. doi: 10.3233/NRE-2010-0554.
A precise estimate of the rates of traumatic brain injury (TBI) in returning combat troops is difficult to establish given the challenges of screening large numbers of military personnel returning from combat deployments. The Brief Traumatic Brain Injury Screen (BTBIS) was implemented in the First Marine Expeditionary Force between 2004 and 2006. Nine percent of the 7909 marines who completed the BTBIS were considered having a positive screen; that is, they endorsed at least one injury mechanism and indicated a change in mental status at the time of injury. The majority of combat-related TBI's were due to multiple injury agents with the next largest group related to blast exposure only. Most importantly, of those who screened positive for TBI 70.5% (n=500) were first identified by the screen. Service members who endorsed items on the BTBIS were contacted for follow-up assessment of persistent symptoms related to TBI and clinical referrals were made as needed. Given the rate of positive TBI screens in this non-referred sample of military personnel returning from a combat deployment, routine TBI screening appears valuable in screening individuals who might not be identified otherwise. Furthermore, this study appears to refute the contention that routine TBI screening will result in an over-identification of TBI in this population.
由于难以对从战斗部署中返回的大量军事人员进行筛选，因此难以准确估计返回战斗部队的创伤性脑损伤（TBI）的发生率。在 2004 年至 2006 年期间，第一海军陆战队远征部队实施了简短创伤性脑损伤筛查（BTBIS）。完成 BTBIS 的 7909 名海军陆战队员中有 9%被认为有阳性筛查结果；也就是说，他们至少认可一种损伤机制，并表示在受伤时精神状态发生了变化。大多数与战斗相关的 TBI 是由多种损伤因素引起的，其次最大的一组与爆炸暴露有关。最重要的是，在 TBI 筛查阳性的人中，有 70.5%（n=500）是通过筛查首次发现的。对 BTBIS 上认可项目的现役人员进行了接触，以对与 TBI 相关的持续性症状进行后续评估，并根据需要进行临床转诊。鉴于从战斗部署中返回的军事人员中非转诊样本中 TBI 筛查阳性的比率，常规 TBI 筛查似乎对筛选否则可能无法识别的个体很有价值。此外，这项研究似乎反驳了常规 TBI 筛查将导致该人群中 TBI 过度识别的论点。
