Brickell Tracey A, Lange Rael T, French Louis M
Defense and Veterans Brain Injury Center, 8901 Wisconsin Avenue, Bethesda, MD 20889.
Mil Med. 2014 Aug;179(8):827-38. doi: 10.7205/MILMED-D-13-00506.
This study examined health-related quality of life within the first 5 years following concurrent mild traumatic brain injury (MTBI) and polytrauma. Participants were 167 U.S. service members who had sustained a MTBI who had completed a brief neurobehavioral evaluation within 3 months postinjury and at least one telephone follow-up interview at 6 (n = 46), 12 (n = 89), 24 (n = 54), 36 (n = 42), 48 (n = 30) or 60 months (n = 25) postinjury. Within the first 5 years postinjury, service members reported ongoing headaches (67.4% to 92.0%), bodily pain (66.7% to 88.9%), medication use (71.7% to 92.0%), mental health treatment (28.3% to 60.0%), and the need for help with daily activities (18.5% to 40.0%). Problematic alcohol consumption was common within the first 24 months postinjury (23.9% to 29.2%). Many service members were working for pay (36.0% to 70.8%) though many reported a decline in work quality (16.0% to 30.4%). Despite ongoing symptom reporting, many service members reported that their medications were effective (43.3% to 80.0%), good/excellent health status (68.0% to 80.0%), and life satisfaction (79.6% to 90.5%). A minority reported suicidal or homicidal ideation (5.6% to 14.8%). Recovery from MTBI in a military setting is complex and multifaceted. Continued support and care for all service members who sustain a combat-related MTBI with polytrauma is recommended, regardless of the presence or absence of symptom reporting within the first few months postinjury.
本研究调查了同时发生轻度创伤性脑损伤（MTBI）和多发伤后的前5年内与健康相关的生活质量。参与者为167名美国军人，他们遭受了MTBI，并在受伤后3个月内完成了简短的神经行为评估，且在受伤后6个月（n = 46）、12个月（n = 89）、24个月（n = 54）、36个月（n = 42）、48个月（n = 30）或60个月（n = 25）时至少接受了一次电话随访访谈。在受伤后的前5年内，军人报告持续存在头痛（67.4%至92.0%）、身体疼痛（66.7%至88.9%）、使用药物（71.7%至92.0%）、接受心理健康治疗（28.3%至60.0%）以及需要日常活动帮助（18.5%至40.0%）。受伤后的前24个月内，问题性饮酒很常见（约23.9%至29.2%）。许多军人有工作收入（36.0%至70.8%），尽管许多人报告工作质量下降（16.0%至30.4%）。尽管持续有症状报告，但许多军人表示他们的药物有效（43.3%至80.0%）、健康状况良好/极佳（68.0%至80.0%）以及生活满意度较高（79.6%至90.5%）。少数人报告有自杀或杀人念头（5.6%至14.8%）。在军事环境中从MTBI恢复是复杂且多方面的。建议对所有遭受与战斗相关的MTBI并发多发伤的军人持续提供支持和护理，无论受伤后最初几个月是否有症状报告。
