Trajectory of Postconcussive Symptoms 12 Months After Deployment in Soldiers With and Without Mild Traumatic Brain Injury: Warrior Strong Study
Trajectory of Postconcussive Symptoms 12 Months After Deployment in Soldiers With and Without Mild Traumatic Brain Injury: Warrior Strong Study
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DOI：
10.1093/aje/kwy199
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发表时间：
2019-01-01
影响因子：
5
通讯作者：
Scher, Ann I.
中科院分区：
文献类型：
--
作者：
Ferdosi, Hamid;Schwab, Karen A.;Scher, Ann I.
我们分析了来自2个美国陆军基地，卡森堡和布拉格堡（2009年至2015年）的最近部署的士兵队列的数据。在返回后的几天内以及3、6和12个月时，对部署时有和没有轻度创伤性脑损伤（mTBI）近期病史的士兵进行了评估。有mTBI的患者比无mTBI的患者更可能将1个脑震荡后症状认定为严重和/或非常严重（47% vs. 21%，基线;调整的相对风险（RR）= 1.71，95%置信区间：1.51，1.93，所有时间点），在调整创伤后应激障碍后仍显着（校正RR = 1.34，95%置信区间：1.20，1.50）。随着时间的推移，3种最常见的基线症状的患病率和相对风险保持不变：睡眠问题（RR = 2.19）、健忘（RR = 2.56）和易怒（RR = 2.73）。头痛的模式略有不同（基线，RR = 3.44; 12个月，RR = 3.26），这是由于没有mTBI的头痛患病率增加。临床相关的脑震荡后症状的患病率在1年的随访中保持相对稳定，无论症状是否与脑震荡相关。最近mTBI的服务成员报告的症状比那些没有在所有时间点。
We analyzed data from a cohort of recently deployed soldiers from 2 US Army bases, Fort Carson and Fort Bragg (2009 to 2015). Soldiers with and without a recent history of mild traumatic brain injury (mTBI) on deployment were evaluated within days of return and at 3, 6, and 12 months. Those with mTBI were more likely than those without to endorse 1 postconcussive symptom as severe and/or very severe (47% vs. 21%, baseline; adjusted relative risk (RR) = 1.71, 95% confidence interval: 1.51, 1.93, all time points), which remained significant after adjusting for posttraumatic stress disorder (adjusted RR = 1.34, 95% confidence interval: 1.20, 1.50). Prevalence and relative risks for 3 of the most common baseline symptoms remained constant over time: sleep problems (RR = 2.19), forgetfulness (RR = 2.56), and irritability (RR = 2.73). The pattern was slightly different for headache (baseline, RR = 3.44; 12 months, RR = 3.26), due to increased prevalence of headache in those without mTBI. The prevalence of clinically relevant postconcussive symptoms remained relatively constant over 1 year of follow-up, whether or not symptoms were associated with concussion. Service members with recent mTBI reported more symptoms than those without at all time points.