Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Division of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Arch Phys Med Rehabil. 2014 Mar;95(3 Suppl):S230-7. doi: 10.1016/j.apmr.2013.08.297.
The World Health Organization Collaborating Centre Task Force on Mild Traumatic Brain Injury (MTBI) published its findings on the prognosis of MTBI in 2004. This is an update of that review with a focus on deployed military personnel.
Relevant literature published between January 2001 and February 2012 listed in MEDLINE and 4 other databases.
Controlled trials and cohort and case-control studies were selected according to predefined criteria. After 77,914 titles and abstracts were screened, 13 articles were rated eligible for this review and 3 (23%) with a low risk of bias were accepted. Two independent reviewers critically appraised eligible studies using a modification of the Scottish Intercollegiate Guidelines Network criteria.
The reviewers independently extracted data from eligible studies and produced evidence tables.
The evidence was synthesized qualitatively and presented in evidence tables. Our findings are based on 3 studies of U.S. military personnel who were deployed in Iraq or Afghanistan. We found that military personnel with MTBI report posttraumatic stress disorder and postconcussive symptoms. In addition, reporting of postconcussive symptoms differed on the basis of levels of combat stress the individuals experienced. The evidence suggests a slight decline in neurocognitive function after MTBI, but this decline was in the normal range of brain functioning.
We found limited evidence that combat stress, posttraumatic stress disorder, and postconcussive symptoms affect recovery and prognosis of MTBI in military personnel. Additional high-quality research is needed to fully assess the prognosis of MTBI in military personnel.
世界卫生组织协作中心脑外伤（MTBI）任务组于 2004 年发布了其关于 MTBI 预后的研究结果。这是对该综述的更新，重点关注部署的军事人员。
在 MEDLINE 和其他 4 个数据库中列出了 2001 年 1 月至 2012 年 2 月期间发表的相关文献。
根据预设标准选择了对照试验和队列研究和病例对照研究。在筛选了 77,914 个标题和摘要后，有 13 篇文章被评为符合本综述标准，其中 3 篇（23%）偏倚风险低的文章被接受。两名独立的审查员使用苏格兰校际指南网络标准的修改版对合格研究进行了批判性评估。
审查员从合格研究中独立提取数据并制作证据表。
定性综合证据并在证据表中呈现。我们的研究结果基于 3 项针对在伊拉克或阿富汗部署的美国军事人员的研究。我们发现，患有 MTBI 的军人报告创伤后应激障碍和脑震荡后症状。此外，根据个人经历的战斗应激水平，报告的脑震荡后症状也有所不同。证据表明，MTBI 后神经认知功能略有下降，但这种下降处于大脑正常功能范围内。
我们发现有限的证据表明战斗应激、创伤后应激障碍和脑震荡后症状会影响军事人员 MTBI 的恢复和预后。需要更多高质量的研究来全面评估军事人员 MTBI 的预后。
