Mullinax Lcdr Ross A, Grunwald Lindsay, Banaag Amanda, Olsen Cara, Koehlmoos Tracey P
Department of Preventive Medicine and Biostatistics, 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. 2023 May 16;188(5-6):e1094-e1101. doi: 10.1093/milmed/usab432.
Medical readiness to deploy is an increasingly important issue within the military. Musculoskeletal back pain is one of the most common medical problems that affects service members. This study demonstrates the associations between risk factors and the prevalence of musculoskeletal back pain among active duty sailors and Marines within the Department of the Navy (DoN).
Utilizing the Military Health System Data Repository, we conducted a retrospective cross-sectional review of administrative healthcare claim data for all active duty DoN personnel with at least one medical encounter during fiscal years 2009-2015. For each fiscal year, we identified all claims with an ICD-9 code for back pain and calculated prevalence. We compared those with and without back pain across all variables (age, gender, rank, race, body mass index, tobacco use, occupation, and branch of service) using chi-square analysis. Unadjusted and adjusted log-binomial regressions were used to calculate prevalence ratios and examine associated risk factors for back pain.
The number of active duty subjects per fiscal year ranged from 424,460 to 437,053. The prevalence of back pain showed an upward trend, ranging from 9.99% in 2009 to 12.09% in 2015. Personnel aged 35 years and older had the strongest adjusted prevalence ration (APR) for back pain (APR 2.59; 95% CI, 2.53-2.66). There were also strong associations with obese body mass index (APR 1.76; 95% CI, 1.66-1.86), overweight body mass index (APR 1.29; 95% CI, 1.27-1.32), and tobacco use (APR 1.39; 95% CI, 1.36-1.42). Females were more likely to have back pain than males (APR 1.43; 95% CI, 1.40-1.47) and Marines more likely than sailors (APR 1.39; 95% CI, 1.36-1.42). The occupation with the highest prevalence ratio was healthcare (APR 1.34; 95% CI, 1.29-1.40) when compared to the reference group of combat specialists.
There was an increasing prevalence of back pain across the DoN from 2009 to 2015. Different occupational categories demonstrate different prevalence of back pain. Surprisingly, combat occupations and aviators were among the groups with the lowest prevalence. Lifestyle factors such as excess body weight and use of tobacco products are clearly associated with increased prevalence. These results could inform military leaders with regard to setting policies that could increase medical readiness.
军事行动中的医疗准备情况在军队内部日益成为一个重要问题。肌肉骨骼性背痛是影响军人的最常见医疗问题之一。本研究展示了海军部（DoN）现役水手和海军陆战队队员中，风险因素与肌肉骨骼性背痛患病率之间的关联。
利用军事健康系统数据存储库，我们对2009 - 2015财年期间至少有一次医疗就诊记录的所有现役DoN人员的行政医疗索赔数据进行了回顾性横断面审查。对于每个财年，我们识别出所有带有背痛ICD - 9编码的索赔记录并计算患病率。我们使用卡方分析比较了在所有变量（年龄、性别、军衔、种族、体重指数、吸烟情况、职业和军种）方面有背痛和无背痛的人员。未调整和调整后的对数二项回归用于计算患病率比并检查背痛的相关风险因素。
各财年现役受试者数量从424,460人到437,053人不等。背痛患病率呈上升趋势，从2009年的9.99%升至2015年的12.09%。35岁及以上人员背痛的调整患病率比（APR）最高（APR 2.59；95%可信区间，2.53 - 2.66）。肥胖体重指数（APR 1.76；95%可信区间，1.66 - 1.86）、超重体重指数（APR 1.29；95%可信区间，1.27 - 1.32）和吸烟情况（APR 1.39；95%可信区间，1.36 - 1.42）也存在强关联。女性比男性更易患背痛（APR 1.43；95%可信区间，1.40 - 1.47），海军陆战队队员比水手更易患背痛（APR 1.39；95%可信区间，1.36 - 1.42）。与战斗专家这一参照组相比，患病率比最高的职业是医疗保健行业（APR 1.34；95%可信区间，1.29 - 1.40）。
2009年至2015年期间，整个DoN的背痛患病率呈上升趋势。不同职业类别显示出不同的背痛患病率。令人惊讶的是，战斗职业人员和飞行员是患病率最低的群体之一。超重和使用烟草制品等生活方式因素显然与患病率增加有关。这些结果可为军事领导人制定可提高医疗准备情况的政策提供参考。
