Johnson Lucas A, Eick-Cost Angelia, Jeffries Vicki, Russell Kevin, Otto Jean Lin
Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, 4301 Jones Bridge Road, A-1040 A, Bethesda, MD 20814-4712.
Armed Forces Health Surveillance Center, 11800 Tech Road, Suite 220, Silver Spring, MD 20904.
Mil Med. 2015 Feb;180(2):208-15. doi: 10.7205/MILMED-D-14-00268.
Evaluate the risk of developing an alcohol use disorder (AUD) or other drug use disorder (ODUD) in U.S. service members (SMs) after incident traumatic brain injury (TBI) in both the deployed and the nondeployed setting.
Retrospective cohort study of U.S. SMs who served on active duty from January 1, 2008 to December 31, 2010. The exposed cohort consisted of SMs who received an incident diagnosis of TBI during the exposure period. The unexposed cohort was populated with a 10% random sample of SMs with any other medical diagnosis over the exposure period.
After adjusting for various demographic factors, TBI severity, historic diagnosis of post-traumatic stress disorder (PTSD), comorbid PTSD, and comorbid mental health outcomes, the TBI cohort (n = 53,817) demonstrated elevated incident rate ratio of developing AUD (adjusted incidence rate ratios (IRR) 1.5, 95% confidence interval (CI) 1.4, 1.6, p < 0.0001) as compared to an unexposed cohort (n = 151,776). The TBI cohort did not demonstrate elevated risk of ODUD as compared to the unexposed cohort (adjusted IRR 1.0, 95% CI 1.0, 1.2, p = 0.178).
U.S. SMs diagnosed with incident TBI demonstrated increased risk of developing an AUD within 1 year of incident TBI as compared to SMs without diagnosed TBI.
评估美国现役军人在部署和非部署环境中发生创伤性脑损伤（TBI）后，患酒精使用障碍（AUD）或其他药物使用障碍（ODUD）的风险。
对2008年1月1日至2010年12月31日期间现役的美国军人进行回顾性队列研究。暴露队列由在暴露期间被确诊为TBI的军人组成。非暴露队列是从暴露期间有任何其他医学诊断的军人中随机抽取10%的样本组成。
在对各种人口统计学因素、TBI严重程度、创伤后应激障碍（PTSD）的既往诊断、共病PTSD以及共病心理健康结果进行调整后，与非暴露队列（n = 151,776）相比，TBI队列（n = 53,817）患AUD的发病率比值升高（调整后的发病率比值（IRR）为1.5，95%置信区间（CI）为1.4, 1.6，p < 0.0001）。与非暴露队列相比，TBI队列患ODUD的风险没有升高（调整后的IRR为1.0，95%CI为1.0, 1.2，p = 0.178）。
与未被诊断为TBI的军人相比，被诊断为新发TBI的美国军人在发生TBI后1年内患AUD的风险增加。
