Army Public Health Center (APHC), Directorate of Clinical Public Health and Epidemiology (CHPE), Injury Prevention Division (IPD), United States.
Army Public Health Center (APHC), Directorate of Clinical Public Health and Epidemiology (CHPE), Injury Prevention Division (IPD), United States.
J Sci Med Sport. 2019 Sep;22(9):997-1003. doi: 10.1016/j.jsams.2019.04.001. Epub 2019 Apr 5.
To describe the etiologic distribution of all injuries among U.S. Army Active Duty soldiers by causal energy categories.
Retrospective cohort, descriptive analysis.
Injury was defined as the interruption of tissue function caused by an external energy transfer (mechanical, thermal, radiant, nuclear, chemical, or electrical energy). A comprehensive injury matrix standardized categories by causal energies, body locations, and injury types. Categories differentiated acute (ACT) from cumulative micro-traumatic (CMT) overuse injuries, and musculoskeletal injuries (MSKI) from those affecting other or multiple body systems (non-MSKI). International Classification of Diseases (ICD) diagnoses codes were organized into established categories. The matrix was applied to electronic health records for U.S. Army soldiers in 2017.
Mechanical energy transfers caused most injuries (97%, n = 809,914): 76% were CMT overuse and the remaining were ACT (<21%). The majority (83%) were MSKI (71% CMT, 12% ACT). While almost one-half (47%) were to lower extremities (38% CMT, 9% ACT) the most frequently injured anatomical sites were the knee and lower back (16% each, primarily CMT).
For the first time all soldiers' injuries have been presented in the same context for consistent comparisons. Findings confirm the vast majority of injuries in this physically-active population are MSKI, and most are CMT MSKI. A very small portion are non-MSKI or injuries caused by non-mechanical energy (e.g., heat- or cold-weather). Most Army injuries are to the lower extremities as a grouped body region, but additional matrix specificity indicates the most injured anatomical locations are the knee, lower back, and shoulder.
按致伤能量类别描述美国现役陆军士兵所有损伤的病因分布。
回顾性队列，描述性分析。
损伤定义为组织功能因外部能量转移（机械、热、辐射、核、化学或电能）而中断。一个综合的损伤矩阵通过致伤能量、身体部位和损伤类型对类别进行了标准化。分类区分了急性（ACT）和累积性微创伤（CMT）过度使用损伤，以及肌肉骨骼损伤（MSKI）和影响其他或多个身体系统的损伤（非-MSKI）。国际疾病分类（ICD）诊断代码被组织到既定类别中。该矩阵应用于 2017 年美国陆军士兵的电子健康记录。
机械能量转移导致了大多数损伤（97%，n=809914）：76%是 CMT 过度使用，其余是 ACT（<21%）。大多数（83%）是 MSKI（71%是 CMT，12%是 ACT）。虽然近一半（47%）是下肢（38%是 CMT，9%是 ACT），但受伤最频繁的解剖部位是膝盖和下背部（各占 16%，主要是 CMT）。
这是第一次将所有士兵的损伤在同一背景下呈现，以便进行一致的比较。研究结果证实，在这个身体活跃的人群中，绝大多数损伤是 MSKI，而且大多数是 CMT MSKI。极少数是非 MSKI 或由非机械能量（如热或冷天气）引起的损伤。大多数陆军损伤是下肢作为一个整体身体区域，但矩阵的额外特异性表明，受伤最严重的解剖部位是膝盖、下背部和肩部。
