Waterman Brian R, Liu Jet, Newcomb Ronald, Schoenfeld Andrew J, Orr Justin D, Belmont Philip J
Brian R. Waterman, Department of Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center, 5005 North Piedras Street, El Paso, TX 79920-5001.
Am J Sports Med. 2013 Nov;41(11):2545-9. doi: 10.1177/0363546513497922. Epub 2013 Aug 2.
Chronic exertional compartment syndrome (CECS) is a common source of lower extremity pain in physically active military service members. While anatomic risk factors of CECS have been proposed, there is no existing study that evaluates the correlation of demographic and occupational risk factors and the overall incidence rate of CECS in an active military population.
Young, enlisted service members in the United States (US) ground military forces would demonstrate higher incidence rates of CECS in the study population because of greater exposure to at-risk dismounted activity on the battlefield and in training.
Cohort study (prevalence); Level of evidence, 2.
A retrospective study of all US active military service members with diagnosed nontraumatic exertional compartment syndrome of the lower extremity (code 729.72 in the International Classification of Diseases, 9th Edition) between 2006 and 2011 was performed using the Defense Medical Epidemiology Database. Demographic and occupational risk factors such as sex, age, race, branch of military service, and military rank were individually subcategorized, and cumulative and subgroup incidence rates of CECS were calculated using a multivariate Poisson regression model.
A total of 4100 diagnosed cases of CECS were identified within an at-risk population of 8,320,201, which correlates to an incidence rate of 0.49 cases per 1000 person-years. The annual adjusted incidence rate of CECS increased from 0.06 cases per 1000 person-years in 2006 to 0.33 cases per 1000 person-years in 2009. Increasing chronological age, female sex, white race, junior enlisted rank, and Army service were significantly correlated with an elevated risk for CECS.
This study systematically evaluated the epidemiology of CECS among an idealized subset at risk for this condition. Sex, age, race, military rank, and branch of service were all important factors associated with the incidence of CECS in this physically active population.
慢性运动性骨筋膜室综合征(CECS)是身体活跃的军人下肢疼痛的常见原因。虽然已经提出了CECS的解剖学危险因素,但尚无现有研究评估人口统计学和职业危险因素与现役军人中CECS总体发病率之间的相关性。
由于在美国地面部队中服役的年轻现役军人在战场和训练中更多地接触有风险的徒步活动,他们在研究人群中CECS的发病率会更高。
队列研究(患病率);证据等级,2级。
使用国防医疗流行病学数据库对2006年至2011年间所有被诊断为下肢非创伤性运动性骨筋膜室综合征(国际疾病分类第9版中的代码729.72)的美国现役军人进行回顾性研究。对性别、年龄、种族、军种和军衔等人口统计学和职业危险因素进行单独分类,并使用多变量泊松回归模型计算CECS的累积发病率和亚组发病率。
在8320201名有风险的人群中,共确定了4100例CECS确诊病例,发病率为每1000人年0.49例。CECS的年度调整发病率从2006年的每1000人年0.06例增加到2009年的每1000人年0.33例。年龄增长、女性、白人种族、初级入伍军衔和陆军服役与CECS风险升高显著相关。
本研究系统地评估了CECS在该疾病理想的高危亚组人群中的流行病学情况。性别、年龄、种族、军衔和军种都是与这一身体活跃人群中CECS发病率相关的重要因素。