Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, 92106, USA.
Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA.
Qual Life Res. 2023 Jul;32(7):1971-1980. doi: 10.1007/s11136-023-03367-4. Epub 2023 Mar 10.
To examine the relationship between deployment-related concussion and long-term health-related quality of life (HRQoL) among injured US military personnel.
The study sample included 810 service members with deployment-related injuries between 2008 and 2012 who responded to a web-based longitudinal health survey. Participants were categorized into three injury groups: concussion with loss of consciousness (LOC; n = 247), concussion without LOC (n = 317), or no concussion (n = 246). HRQoL was measured using the 36-Item Short Form Health Survey physical and mental component summary (PCS and MCS) scores. Current post-traumatic stress disorder (PTSD) and depression symptoms were examined. Multivariable linear regression models assessed the effects of concussion on PCS and MCS scores, while controlling for covariates.
A lower PCS score was observed in participants with concussion with LOC (B = - 2.65, p = 0.003) compared with those with no history of concussion. Symptoms of PTSD (PCS: B = - 4.84, p < 0.001; MCS: B = - 10.53, p < 0.001) and depression (PCS: B = - 2.85, p < 0.001; MCS: B = - 10.24, p < 0.001) were the strongest statistically significant predictors of lower HRQoL.
Concussion with LOC was significantly associated with lower HRQoL in the physical domain. These findings affirm that concussion management should integrate physical and psychological care to improve long-term HRQoL and warrant a more detailed examination of causal and mediating mechanisms. Future research should continue to incorporate patient-reported outcomes and long-term follow-up of military service members to further define the lifelong impact of deployment-related concussion.
研究与部署相关的脑震荡与受伤美军士兵的长期健康相关生活质量（HRQoL）之间的关系。
本研究样本包括 2008 年至 2012 年期间因部署相关损伤而接受网络纵向健康调查的 810 名现役军人。参与者分为三组损伤：伴意识丧失的脑震荡（LOC；n=247）、不伴 LOC 的脑震荡（n=317）和无脑震荡（n=246）。使用 36 项简短健康调查问卷的身体和精神成分综合评分（PCS 和 MCS）来衡量 HRQoL。检查当前创伤后应激障碍（PTSD）和抑郁症状。多变量线性回归模型评估了脑震荡对 PCS 和 MCS 评分的影响，同时控制了协变量。
与无脑震荡史的参与者相比，伴 LOC 的脑震荡参与者的 PCS 评分较低（B=−2.65，p=0.003）。PTSD 症状（PCS：B=−4.84，p<0.001；MCS：B=−10.53，p<0.001）和抑郁症状（PCS：B=−2.85，p<0.001；MCS：B=−10.24，p<0.001）是 HRQoL 较低的最强统计学显著预测因素。
LOC 伴脑震荡与生理领域的 HRQoL 显著降低相关。这些发现证实了脑震荡管理应整合身体和心理护理，以提高长期 HRQoL，并需要更详细地研究因果和中介机制。未来的研究应继续纳入患者报告的结果和对现役军人的长期随访，以进一步定义与部署相关的脑震荡的终身影响。
