Hai Tajrina, Agimi Yll, Deressa Tesfaye, Haddad Olivia
Traumatic Brain Injury Center of Excellence, Silver Spring, MD 20910, USA.
Compass Government Solutions, Annapolis, MD 21401, USA.
Mil Med. 2025 Feb 27;190(3-4):e830-e837. doi: 10.1093/milmed/usae492.
To understand the mechanisms of injury and demographic risk factors associated with traumatic brain injury (TBI) patients among active and reserve service members in the U.S. Military before and during the COVID-10 pandemic.
Active and reserve service members diagnosed with an incident TBI from January 2019 through September 2021 were selected. Traumatic brain injury patients diagnosed before March 1, 2020 were categorized as pre-COVID (PC), and patients diagnosed on or after March 1, 2020 were categorized as the intra-COVID (IC) group, aligning closely with the date when the World Health Organization officially proclaimed the pandemic. We determined the frequency of causes of injuries associated with TBI separate by sex, age, occupation, and TBI severity. In addition, we conducted multivariate logistic regression analyses to assess the demographic risk factors associated with TBI severity during the PC and IC eras.
Our cohort included 48,562 TBI patients: 22,819 (47.0%) diagnosed during the PC era and 25,743 (53.0%) diagnosed during the IC era. The major mechanisms of injury within our TBI cohort were being struck by/against objects, falls/slips/trips, and motor vehicle traffic accidents before and during the pandemic. The most common causes of TBI were not impacted by COVID, but motor vehicle accidents did increase during the IC era. The mechanisms of injury associated with TBI differed by TBI severity: being struck by or against an object caused more mild and moderate TBI; motor vehicle accidents caused more severe TBI; and firearms was a major cause of penetrating TBI. In addition, the percentage of severe TBI because of firearms rose sharply during the IC era. Further, women were more likely to be diagnosed with mild TBI compared to men.
Military leaders should consider how different causes of injury are associated with differing TBI severities and how certain demographic groups were vulnerable to specific TBI severities when developing injury prevention programs.
了解美国军队现役和预备役军人在新冠疫情之前及期间与创伤性脑损伤（TBI）患者相关的损伤机制和人口统计学风险因素。
选取2019年1月至2021年9月期间被诊断为新发TBI的现役和预备役军人。2020年3月1日前被诊断为创伤性脑损伤的患者被归类为新冠疫情前（PC）组，2020年3月1日及以后被诊断的患者被归类为新冠疫情期间（IC）组，这与世界卫生组织正式宣布疫情的日期密切相关。我们按性别、年龄、职业和TBI严重程度确定了与TBI相关的损伤原因频率。此外，我们进行了多因素逻辑回归分析，以评估PC和IC时代与TBI严重程度相关的人口统计学风险因素。
我们的队列包括48562例TBI患者：22819例（47.0%）在PC时代被诊断，25743例（53.0%）在IC时代被诊断。在我们的TBI队列中，主要损伤机制在疫情之前及期间均为被物体撞击、跌倒/滑倒/绊倒和机动车交通事故。TBI最常见的原因未受新冠疫情影响，但在IC时代机动车事故确实有所增加。与TBI相关的损伤机制因TBI严重程度而异：被物体撞击导致更多轻度和中度TBI；机动车事故导致更严重的TBI；枪支是穿透性TBI的主要原因。此外，在IC时代，因枪支导致的严重TBI百分比急剧上升。此外，与男性相比，女性更易被诊断为轻度TBI。
军事领导人在制定伤害预防计划时，应考虑不同的损伤原因如何与不同的TBI严重程度相关联，以及某些人口群体如何易患特定严重程度的TBI。
