Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival.
Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis survival.
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DOI：
10.1371/journal.pone.0185751
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Kamel F
中科院分区：
文献类型：
--
作者：
Beard JD;Engel LS;Richardson DB;Gammon MD;Baird C;Umbach DM;Allen KD;Stanwyck CL;Keller J;Sandler DP;Schmidt S;Kamel F
退伍军人可能比非退伍军人有更高的肌萎缩侧索硬化症（ALS）死亡率。很少有研究，稀疏的曝光信息和混合的结果，研究了军事相关因素和ALS生存之间的关系。我们评估了美国退伍军人病例中军事相关因素与ALS生存之间的关联。我们跟踪了616例病历证实的病例，从2005年至2010年，在基因和环境暴露的退伍军人与肌萎缩侧索硬化症研究，直到死亡或2013年7月25日，以先到者为准。我们从退伍军人事务部的几个来源确定了重要的状态信息。我们通过标准化的电话访谈获得了关于兵役、部署和39个相关暴露的信息。我们使用考克斯比例风险回归模型来估计风险比（HR）和95%置信区间。我们通过逆概率权重调整了潜在的混杂因素和缺失协变量数据偏倚。我们还使用了逆概率权重来调整病例组中潜在的选择偏倚，该病例组在入组时包括不成比例的长期存活者。在24，267人月的随访期间，我们观察到446例死亡（中位随访时间：28个月）。在1950年之前服役、被部署到第二次世界大战或混合并应用燃烧剂的病例中，存活率较短，HR在1.58和2.57之间。较长的生存期与暴露于以下物质有关：油漆、溶剂或石化物质;武装部队不提供的当地食物;或燃烧剂或橙子剂，HR在0.56和0.73之间。虽然大多数与军事有关的因素与生存无关，但我们观察到的与较短生存期的关联可能很重要，因为退伍军人的数量很大。
Military veterans may have higher rates of amyotrophic lateral sclerosis (ALS) mortality than non-veterans. Few studies, with sparse exposure information and mixed results, have studied relationships between military-related factors and ALS survival. We evaluated associations between military-related factors and ALS survival among U.S. military veteran cases. We followed 616 medical record-confirmed cases from enrollment (2005–2010) in the Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis study until death or July 25, 2013, whichever came first. We ascertained vital status information from several sources within the Department of Veterans Affairs. We obtained information regarding military service, deployments, and 39 related exposures via standardized telephone interviews. We used Cox proportional hazards regression models to estimate hazard ratios (HRs) and 95% confidence intervals. We adjusted for potential confounding and missing covariate data biases via inverse probability weights. We also used inverse probability weights to adjust for potential selection bias among a case group that included a disproportionate number of long-term survivors at enrollment. We observed 446 deaths during 24,267 person-months of follow-up (median follow-up: 28 months). Survival was shorter for cases who served before 1950, were deployed to World War II, or mixed and applied burning agents, with HRs between 1.58 and 2.57. Longer survival was associated with exposure to: paint, solvents, or petrochemical substances; local food not provided by the Armed Forces; or burning agents or Agent Orange in the field with HRs between 0.56 and 0.73. Although most military-related factors were not associated with survival, associations we observed with shorter survival are potentially important because of the large number of military veterans.
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影响因子：
4.4
作者：
Cedarbaum, JM;Stambler, N;Nakanishi, A
通讯作者：
Nakanishi, A
影响因子：
5.5
作者：
Beard, John D.;Kamel, Freya
通讯作者：
Kamel, Freya
影响因子：
5
作者：
Cole, Stephen R.;Hernan, Miguel A.
通讯作者：
Hernan, Miguel A.
DOI：
10.1111/j.2517-6161.1995.tb02031.x
发表时间：
1995-01-01
影响因子：
5.8
作者：
BENJAMINI, Y;HOCHBERG, Y
通讯作者：
HOCHBERG, Y
影响因子：
6.8
作者：
AKAIKE, H
通讯作者：
AKAIKE, H