Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD 20817, USA.
Mil Med. 2022 Jul 1;187(7-8):e814-e820. doi: 10.1093/milmed/usab217.
Physical and medical readiness have emerged as a top priority in the army over the last decade. With this emphasis on deployment readiness, it is important to understand key risk factors attributed to common medical problems that arise in our soldiers, including low back pain. The purpose of this study is to elucidate demographic and lifestyle risk factors which would result in seeking medical care for musculoskeletal low back pain among active duty army personnel.
A cross-sectional retrospective study investigating all active duty soldiers between October 1, 2016 and September 30, 2018 was performed using the existing Military Health System Data Repository to retrospectively review administrative claims data. Our study queried 39 unique International Classification of Disease codes, 10th Revision codes for low back pain to determine a positive case. We compared those with and without back pain across all variables using a chi-square analysis in SAS. Multivariate logistic analysis was performed to adjust for confounding within any single proposed risk factor and the six other proposed risk factors.
Six hundred fifty seven thousand and six thirty soldiers met inclusion criteria; 228,184 of whom had a medical encounter for low back pain (34.7%). All of the proposed risk factors included statistically significant unadjusted and adjusted odds ratios (ORs) with age conferring the greatest risk in soldiers aged 50-59 with an OR of 2.89 (2.73-3.05) compared to those aged 20-29. Obesity-adjusted OR was 1.77 (1.74-1.80) compared to those who were normal weight. Senior Enlisted status-adjusted OR was 1.34 (1.32-1.36). Females were 66% more likely to have low back pain compared to males with an OR of 1.66 (1.63-1.68).
Disease burden for low back pain tends to be high in the U.S. Army with 34.7% of service members experiencing low back pain. Older age, obesity, and being an enlisted, female service member are risk factors for these musculoskeletal injuries, which is in agreement with previously reported literature on the topic. To mitigate the burden of low back pain, policies and incentives to encourage healthy body mass index and lifestyle are needed. The results of this work inform future studies aimed at further delineating the risk factors found in this study.
在过去十年中，身体和医疗准备已成为军队的首要任务。随着对部署准备的重视，了解导致士兵出现常见医疗问题的关键风险因素非常重要，包括下腰痛。本研究的目的是阐明导致现役军人因肌肉骨骼下腰痛寻求医疗的人口统计学和生活方式风险因素。
使用现有的军事医疗系统数据存储库，对 2016 年 10 月 1 日至 2018 年 9 月 30 日期间的所有现役士兵进行了一项横断面回顾性研究，以回顾性审查行政索赔数据。我们的研究使用了 39 个独特的国际疾病分类第 10 版代码查询了下腰痛的代码，以确定阳性病例。我们使用 SAS 中的卡方分析比较了有和没有背痛的所有变量。进行多变量逻辑分析以调整任何单一拟议风险因素和其他六个拟议风险因素内的混杂因素。
657630 名士兵符合纳入标准；其中 228184 人因下腰痛接受了医疗治疗（34.7%）。所有拟议的风险因素均具有统计学意义的未调整和调整后的优势比（OR），年龄是 50-59 岁的士兵中最大的风险因素，OR 为 2.89（2.73-3.05），与 20-29 岁的士兵相比。肥胖调整后的 OR 为 1.77（1.74-1.80），与正常体重的人相比。高级入伍状态调整后的 OR 为 1.34（1.32-1.36）。与男性相比，女性患下腰痛的可能性高 66%，OR 为 1.66（1.63-1.68）。
美国陆军的下腰痛疾病负担很高，有 34.7%的现役军人患有下腰痛。年龄较大、肥胖和作为入伍的女性是这些肌肉骨骼损伤的危险因素，这与之前关于该主题的文献报道一致。为了减轻下腰痛的负担，需要制定政策和激励措施来鼓励健康的体重指数和生活方式。这项工作的结果为进一步阐明本研究中发现的风险因素的未来研究提供了信息。
