Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.
Popul Health Metr. 2010 May 24;8:15. doi: 10.1186/1478-7954-8-15.
Complete and accurate ascertainment of mortality is critically important in any longitudinal study. Tracking of mortality is particularly essential among US military members because of unique occupational exposures (e.g., worldwide deployments as well as combat experiences). Our study objectives were to describe the early mortality experience of Panel 1 of the Millennium Cohort, consisting of participants in a 21-year prospective study of US military service members, and to assess data sources used to ascertain mortality.
A population-based random sample (n = 256,400) of all US military service members on service rosters as of October 1, 2000, was selected for study recruitment. Among this original sample, 214,388 had valid mailing addresses, were not in the pilot study, and comprised the group referred to in this study as the invited sample. Panel 1 participants were enrolled from 2001 to 2003, represented all armed service branches, and included active-duty, Reserve, and National Guard members. Crude death rates, as well as age- and sex-adjusted overall and age-adjusted, category-specific death rates were calculated and compared for participants (n = 77,047) and non-participants (n = 137,341) based on data from the Social Security Administration Death Master File, Department of Veterans Affairs (VA) files, and the Department of Defense Medical Mortality Registry, 2001-2006. Numbers of deaths identified by these three data sources, as well as the National Death Index, were compared for 2001-2004.
There were 341 deaths among the participants for a crude death rate of 80.7 per 100,000 person-years (95% confidence interval [CI]: 72.2,89.3) compared to 820 deaths and a crude death rate of 113.2 per 100,000 person-years (95% CI: 105.4, 120.9) for non-participants. Age-adjusted, category-specific death rates highlighted consistently higher rates among study non-participants. Although there were advantages and disadvantages for each data source, the VA mortality files identified the largest number of deaths (97%).
The difference in crude and adjusted death rates between Panel 1 participants and non-participants may reflect healthier segments of the military having the opportunity and choosing to participate. In our study population, mortality information was best captured using multiple data sources.
在任何纵向研究中,完整准确地确定死亡率至关重要。由于美国军人的职业暴露(例如全球部署和作战经历),因此跟踪死亡率尤为重要。我们的研究目的是描述千年队列第 1 组的早期死亡率,该组由参加一项为期 21 年的美国军人职业研究的参与者组成,并评估用于确定死亡率的数据源。
从 2000 年 10 月 1 日的服务名单中选择所有美国军人的基于人群的随机样本(n = 256400)进行研究招募。在这个原始样本中,有 214388 人有有效的邮寄地址,不在试点研究中,并且构成了本研究中称为邀请样本的人群。第 1 组参与者于 2001 年至 2003 年期间入组,代表所有武装部队分支,包括现役、预备役和国民警卫队成员。根据社会安全管理局死亡主文件、退伍军人事务部(VA)档案和国防部医疗死亡率登记处的数据,计算并比较了参与者(n = 77047)和非参与者(n = 137341)的粗死亡率以及年龄和性别调整后的总体死亡率和年龄调整后的特定类别死亡率,2001-2006 年。比较了这三个数据源以及国家死亡指数在 2001-2004 年期间确定的死亡人数。
参与者中有 341 人死亡,粗死亡率为 80.7 / 100,000 人年(95%置信区间[CI]:72.2,89.3),而非参与者中有 820 人死亡,粗死亡率为 113.2 / 100,000 人年(95% CI:105.4,120.9)。年龄调整后的特定类别死亡率突出显示了研究非参与者中始终更高的死亡率。尽管每个数据源都有优点和缺点,但 VA 死亡率文件确定的死亡人数最多(97%)。
第 1 组参与者和非参与者之间的粗死亡率和调整后死亡率的差异可能反映了有机会和选择参加的军队中更健康的部分。在我们的研究人群中,使用多个数据源可以最好地捕获死亡率信息。