All of the authors are with the Defense and Veterans Brain Injury Center, Defense Health Agency, Silver Spring, MD. Yll Agimi is also with Salient CRGT, Springfield, VA. Lemma Ebssa Regasa, Brian Ivins, and Donald Marion are also with General Dynamics Information Technology, Fairfax, VA.
Am J Public Health. 2018 May;108(5):683-688. doi: 10.2105/AJPH.2018.304347. Epub 2018 Mar 22.
To examine the role of Department of Defense policies in identifying theater-sustained traumatic brain injuries (TBIs).
We conducted a retrospective study of 48 172 US military service members who sustained their first lifetime TBIs between 2001 and 2016 while deployed to Afghanistan or Iraq. We used multivariable negative binomial models to examine the changes in TBI incidence rates following the introduction of Department of Defense policies.
Two Army policies encouraging TBI reporting were associated with an increase of 251% and 97% in TBIs identified following their implementation, respectively. Among airmen, the introduction of TBI-specific screening questions to the Post-Deployment Health Assessment was associated with a 78% increase in reported TBIs. The 2010 Department of Defense Directive Type Memorandum 09-033 was associated with another increase of 80% in the likelihood of being identified with a TBI among soldiers, a 51% increase among sailors, and a 124% increase among Marines.
Department of Defense and service-specific policies introduced between 2006 and 2013 significantly increased the number of battlefield TBIs identified, successfully improving the longstanding problem of underreporting of TBIs.
探讨国防部政策在确定战区持续性创伤性脑损伤（TBI）中的作用。
我们对 2001 年至 2016 年间在阿富汗或伊拉克部署期间首次发生终身 TBI 的 48172 名美国军人进行了回顾性研究。我们使用多变量负二项式模型来研究在国防部政策出台后 TBI 发生率的变化。
两项鼓励 TBI 报告的陆军政策在实施后分别使 TBI 识别率增加了 251%和 97%。在飞行员中，在部署后健康评估中引入 TBI 特定筛查问题使报告的 TBI 增加了 78%。2010 年国防部指令型备忘录 09-033 使士兵 TBI 被识别的可能性增加了 80%，水手增加了 51%，海军陆战队增加了 124%。
2006 年至 2013 年期间出台的国防部和特定服务政策显著增加了战场上 TBI 的数量，成功地解决了 TBI 长期报告不足的问题。
