Bullman Tim A, Kang Han K, Smolenski Derek J, Skopp Nancy A, Gahm Gregory A, Reger Mark A
a Office of Public Health , U.S. Department of Veterans Affairs , Washington , D.C.
b Institute for Clinical Research , Washington , D.C.
Traffic Inj Prev. 2017 May 19;18(4):369-374. doi: 10.1080/15389588.2016.1206201. Epub 2016 Sep 2.
We conducted a cohort study of recent wartime veterans to determine the postservice mortality risk due to motor vehicle accidents (MVAs).
Veterans were identified from the Defense Manpower Data Center records. Deployment to te Iraq or Afghanistan war zone was determined from the Contingency Tracking System. Vital status of 317,581 deployed and 964,493 nondeployed veterans was followed from their discharge dates between 2001 to 2007 until earlier of date of death or December 31, 2009. Underlying causes of death were obtained from the National Death Index Plus.
Based on 9,353 deaths (deployed, 1,650; nondeployed, 7,703), of which 779 were MVA deaths as drivers (166; 613), both cohorts had 25 to 24% lower mortality risk from all causes but had 44 to 45% higher risk of MVA deaths relative to the U.S. general population. The higher MVA mortality risk was not associated with deployment to the war zone. After controlling for age, sex, race, marital status, branch of service, and rank, the risk for deployed veterans was comparable to that of nondeployed veterans (hazard ratio = 0.91; 95% confidence interval, 0.77-1.09).
Veterans exhibit significantly higher risk of MVA deaths compared to the U.S. general population. However, deployment to the Iraq or Afghanistan war was not associated with the excess risk.
我们对近期的战时退伍军人进行了一项队列研究，以确定机动车事故（MVA）导致的退伍后死亡风险。
从国防人力数据中心记录中识别退伍军人。根据应急跟踪系统确定是否被部署到伊拉克或阿富汗战区。对317,581名被部署退伍军人和964,493名未被部署退伍军人从2001年至2007年的退伍日期开始进行生命状态跟踪，直至死亡日期或2009年12月31日（以较早者为准）。死亡的根本原因从国家死亡指数升级版中获取。
基于9353例死亡（被部署者1650例，未被部署者7703例），其中779例为驾驶员MVA死亡（被部署者166例，未被部署者613例），两个队列的全因死亡率风险均降低了25%至24%，但相对于美国普通人群，MVA死亡风险高出44%至45%。较高的MVA死亡风险与被部署到战区无关。在控制了年龄、性别、种族、婚姻状况、军种和军衔后，被部署退伍军人的风险与未被部署退伍军人相当（风险比=0.91；95%置信区间，0.77 - 1.09）。
与美国普通人群相比，退伍军人的MVA死亡风险显著更高。然而，被部署到伊拉克或阿富汗战争与这种额外风险无关。
