Piccirillo Amanda L, Packnett Elizabeth R, Cowan David N, Boivin Michael R
Walter Reed Army Institute of Research, Preventive Medicine Branch, Department of Epidemiology, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA; ManTech International Corporation, ManTech Health, 13755 Sunrise Valley Drive, Suite 500, Herndon, VA 20171, USA.
Walter Reed Army Institute of Research, Preventive Medicine Branch, Department of Epidemiology, 503 Robert Grant Avenue, Silver Spring, MD 20910, USA.
Disabil Health J. 2016 Apr;9(2):324-31. doi: 10.1016/j.dhjo.2015.11.005. Epub 2015 Nov 23.
The rate of permanent disability retirement in U.S. Army soldiers and the prevalence of combat-related disabilities have significantly increased over time. Prior research on risk factors associated with disability retirement included soldiers retired prior to conflicts in Iraq and Afghanistan.
To identify risk factors for disability discharge among soldiers enlisted in the U.S. Army during military operations in Iraq and Afghanistan.
In this case-control study, cases included active duty soldiers evaluated for disability discharge. Controls, randomly selected from soldiers with no history of disability evaluation, were matched to cases based on enlistment year and sex. Conditional logistic regression models calculated odds of disability discharge. Attributable fractions estimated burden of disability for specific pre-existing condition categories. Poisson regression models compared risk of disability discharge related to common disability types by deployment and combat status.
Characteristics at military enlistment with increased odds of disability discharge included a pre-existing condition, increased age or body mass index, white race, and being divorced. Musculoskeletal conditions and overweight contributed the largest proportion of disabilities. Deployment was protective against disability discharge or receiving a musculoskeletal-related disability, but significantly increased the risk of disability related to a psychiatric or neurological condition.
Soldiers with a pre-existing condition at enlistment, particularly a musculoskeletal condition, had increased odds of disability discharge. Risk of disability was dependent on condition category when stratified by deployment and combat status. Additional research examining conditions during pre-disability hospitalizations could provide insight on specific conditions that commonly lead to disability discharge.
随着时间的推移，美国陆军士兵的永久性残疾退休率以及与战斗相关的残疾患病率显著增加。先前关于与残疾退休相关风险因素的研究包括在伊拉克和阿富汗冲突之前退休的士兵。
确定在伊拉克和阿富汗军事行动期间入伍的美国陆军士兵中残疾退伍的风险因素。
在这项病例对照研究中，病例包括接受残疾退伍评估的现役士兵。对照组从没有残疾评估史的士兵中随机选取，根据入伍年份和性别与病例进行匹配。条件逻辑回归模型计算残疾退伍的几率。归因分数估计特定预先存在疾病类别的残疾负担。泊松回归模型比较了按部署和战斗状态划分的与常见残疾类型相关的残疾退伍风险。
入伍时残疾退伍几率增加的特征包括预先存在疾病、年龄或体重指数增加、白人种族以及离婚。肌肉骨骼疾病和超重导致的残疾比例最大。部署对残疾退伍或患肌肉骨骼相关残疾有保护作用，但显著增加了患精神或神经疾病相关残疾的风险。
入伍时预先存在疾病的士兵，尤其是肌肉骨骼疾病患者，残疾退伍的几率增加。按部署和战斗状态分层时，残疾风险取决于疾病类别。对残疾前住院期间疾病的进一步研究可以提供对通常导致残疾退伍的特定疾病的见解。
