Elmasry Hoda, Boivin Michael R, Feng Xiaoshu, Packnett Elizabeth R, Cowan David N
Department of Epidemiology, Preventive Medicine Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland (Mss Elmasry, Feng, and Packnett and Drs Boivin and Cowan); and ManTech Health, Herndon, Virginia (Mss Elmasry, Feng, and Packnett and Dr Cowan).
J Head Trauma Rehabil. 2017 Jan/Feb;32(1):E1-E7. doi: 10.1097/HTR.0000000000000229.
To determine the preenlistment and early service risk factors for traumatic brain injury (TBI)-related disability in Army and Marine Corps service members.
Matched case-control design.
TBI disability discharges.
Army and Marine Corps service members with an enlistment record and disability discharge for TBI were included as cases. Controls were selected from the enlisted population with no disability evaluation record and were matched on fiscal year of enlistment, sex, and service at a ratio of 5:1.
Older age at enlistment resulted in a significantly increased risk for TBI disability in the crude and adjusted models (adjusted odds ratio [aOR] = 1.49; 95% confidence interval [CI], 1.16-1.91). An enlistment military occupational specialty (MOS) with a combat arms designation resulted in an almost 3-fold increased odds of TBI disability compared with other MOS categories (aOR = 2.75; 95% CI, 2.46-3.09). This remained a significant risk factor for TBI disability in the multivariate model (aOR = 2.74; 95% CI, 2.45-3.08).
Results from this study help inform the existing body of military TBI research by highlighting the preenlistment demographic and early service risk factors for TBI disability. Further research into the role of age on TBI disability in the military is merited.
确定陆军和海军陆战队现役军人中创伤性脑损伤(TBI)相关残疾的入伍前和早期服役风险因素。
匹配病例对照设计。
TBI残疾退伍。
有入伍记录且因TBI残疾退伍的陆军和海军陆战队现役军人被纳入病例组。对照组从无残疾评估记录的现役人群中选取,按入伍财政年度、性别和军种以5:1的比例进行匹配。
在粗模型和校正模型中,入伍时年龄较大导致TBI残疾风险显著增加(校正优势比[aOR]=1.49;95%置信区间[CI],1.16-1.91)。与其他军事职业专长(MOS)类别相比,具有战斗兵种指定的入伍MOS导致TBI残疾的几率增加近3倍(aOR=2.75;95%CI,2.46-3.09)。在多变量模型中,这仍然是TBI残疾的一个显著风险因素(aOR=2.74;95%CI,2.45-3.08)。
本研究结果通过强调入伍前人口统计学和早期服役TBI残疾风险因素,为现有的军事TBI研究提供了信息。值得对年龄在军事TBI残疾中的作用进行进一步研究。