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脑震荡后症状轨迹:有和无轻度创伤性脑损伤士兵部署后 12 个月的研究。

Trajectory of Postconcussive Symptoms 12 Months After Deployment in Soldiers With and Without Mild Traumatic Brain Injury: Warrior Strong Study.

机构信息

Defense and Veterans Brain Injury Center, TBI Center of Excellence, Silver Spring, Maryland.

Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, DC.

出版信息

Am J Epidemiol. 2019 Jan 1;188(1):77-86. doi: 10.1093/aje/kwy199.

DOI:10.1093/aje/kwy199
PMID:30203085
Abstract

We analyzed data from a cohort of recently deployed soldiers from 2 US Army bases, Fort Carson and Fort Bragg (2009 to 2015). Soldiers with and without a recent history of mild traumatic brain injury (mTBI) on deployment were evaluated within days of return and at 3, 6, and 12 months. Those with mTBI were more likely than those without to endorse ≥1 postconcussive symptom as "severe" and/or "very severe" (47% vs. 21%, baseline; adjusted relative risk (RR) = 1.71, 95% confidence interval: 1.51, 1.93, all time points), which remained significant after adjusting for posttraumatic stress disorder (adjusted RR = 1.34, 95% confidence interval: 1.20, 1.50). Prevalence and relative risks for 3 of the most common baseline symptoms remained constant over time: sleep problems (RR = 2.19), forgetfulness (RR = 2.56), and irritability (RR = 2.73). The pattern was slightly different for headache (baseline, RR = 3.44; 12 months, RR = 3.26), due to increased prevalence of headache in those without mTBI. The prevalence of clinically relevant postconcussive symptoms remained relatively constant over 1 year of follow-up, whether or not symptoms were associated with concussion. Service members with recent mTBI reported more symptoms than those without at all time points.

摘要

我们分析了来自美国陆军 2 个基地(卡森堡和布拉格堡)的最近部署士兵队列的数据(2009 年至 2015 年)。在返回后的几天内以及 3、6 和 12 个月时,评估了有和没有近期轻度创伤性脑损伤(mTBI)的士兵。与没有 mTBI 的士兵相比,有 mTBI 的士兵更有可能报告≥1 项脑震荡后症状为“严重”和/或“非常严重”(47%对 21%,基线;调整后的相对风险(RR)=1.71,95%置信区间:1.51,1.93,所有时间点),这在调整创伤后应激障碍(调整后的 RR = 1.34,95%置信区间:1.20,1.50)后仍然显著。3 种最常见的基线症状的发生率和相对风险在整个随访期间保持不变:睡眠问题(RR = 2.19)、健忘(RR = 2.56)和易怒(RR = 2.73)。由于无 mTBI 的头痛发生率增加,头痛的模式略有不同(基线时 RR = 3.44;12 个月时 RR = 3.26)。无论症状是否与脑震荡相关,在 1 年的随访中,有近期 mTBI 的士兵报告的脑震荡后症状的发生率保持相对稳定。有近期 mTBI 的士兵在所有时间点报告的症状都比没有 mTBI 的士兵多。

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