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通过 LIMBIC-CENC 多中心轻度创伤性脑损伤研究的 ICD 编码确定的痴呆病例的临床特征。

Clinical features of dementia cases ascertained by ICD coding in LIMBIC-CENC multicenter study of mild traumatic brain injury.

机构信息

Department of Physical Medicine and Rehabilitation (PM&R), School of Medicine, Virginia Commonwealth University, and Central Virginia VA Healthcare System, Richmond, Virginia, USA.

Traumatic Brain Injury Model Systems, Polytrauma Rehabilitation Center, South Texas Veterans Healthcare System, San Antonio, Texas, USA.

出版信息

Brain Inj. 2022 Apr 16;36(5):644-651. doi: 10.1080/02699052.2022.2033849. Epub 2022 Feb 2.

Abstract

OBJECTIVE

Describe dementia cases identified through International Classification of Diseases (ICD) coding in the Long-term Impact of Military-relevant Brain Injury Consortium - Chronic Effects of Neurotrauma Consortium (LIMBIC-CENC) multicenter prospective longitudinal study (PLS) of mild traumatic brain injury (mTBI).

DESIGN

Descriptive case series using cross-sectional data.

METHODS

Veterans Affairs (VA) health system data including ICD codes were obtained for 1563 PLS participants through the VA Informatics and Computing Infrastructure (VINCI). Demographic, injury, and clinical characteristics of Dementia positive and negative cases are described.

RESULTS

Five cases of dementia were identified, all under 65 years old. The dementia cases all had a history of blast-related mTBI and all had self-reported functional problems and four had PTSD symptomatology at the clinical disorder range. Cognitive testing revealed some deficits especially in the visual memory and verbal learning and memory domains, and that two of the cases might be false positives.

CONCLUSIONS

ICD codes for early dementia in the VA system have specificity concerns, but could be indicative of cognitive performance and self-reported cognitive function. Further research is needed to better determine links to blast exposure, blast-related mTBI, and PTSD to early dementia in the military population.

摘要

目的

通过国际疾病分类(ICD)编码描述 LIMBIC-CENC(军事相关脑损伤联盟-慢性神经创伤影响联盟)多中心前瞻性纵向研究(PLS)中轻度创伤性脑损伤(mTBI)中确定的痴呆病例。

设计

使用横断面数据的描述性病例系列。

方法

通过 VA 信息学和计算基础设施(VINCI)从 VA 健康系统数据中获取了 1563 名 PLS 参与者的 ICD 代码。描述了痴呆阳性和阴性病例的人口统计学、损伤和临床特征。

结果

共发现 5 例痴呆,均小于 65 岁。痴呆病例均有爆炸相关 mTBI 病史,均有自述的功能问题,其中 4 例有 PTSD 症状达到临床障碍范围。认知测试显示出一些缺陷,特别是在视觉记忆和言语学习和记忆领域,其中 2 例可能为假阳性。

结论

VA 系统中早期痴呆的 ICD 编码存在特异性问题,但可能表明认知表现和自我报告的认知功能。需要进一步研究以更好地确定与爆炸暴露、爆炸相关 mTBI 和 PTSD 与军事人群中早期痴呆的联系。

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