Risk Factors for Medical Disability in US Enlisted Marines: Fiscal Years 2001 to 2009
Risk Factors for Medical Disability in US Enlisted Marines: Fiscal Years 2001 to 2009
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DOI：
10.7205/milmed-d-11-00250
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发表时间：
2012-02-01
影响因子：
1.2
通讯作者：
Niebuhr, David W.
中科院分区：
文献类型：
--
作者：
Sikorski, Cynthia;Emerson, Maura A.;Niebuhr, David W.
目的：评估与美国海军陆战队医疗残疾相关的因素。方法：采用双因素和多因素Logistic回归分析方法，对11,554例美国海军陆战队入伍士兵2001-2009财政年度的医疗残疾病例进行病例对照研究，其中42,216例对照病例在入伍当年以4：1的比例匹配。结果：入选时年龄和体重指数的增加与医疗残疾的几率更高相关。女性(调整后的优势比[ORADJ]=1.3，95%可信区间[CI]=1.2-1.3)患残疾的几率比男性高。观察到“健康勇士效应”，因为那些部署的人(ORADI=0.48，95%CI=0.46-0.50)比那些没有部署的人身体残疾的几率更低。入选时的医疗豁免(ORADI=1.12，95%CI=1.01-1.23)增加了医疗残疾的几率。结论：需要继续监测残疾评估系统，以帮助制定预防措施，并帮助政策制定者在服役人员的生命周期内建立基于证据的政策，包括加入、部署和保留标准。
Objective: To assess factors associated with medical disability in the U.S. Marine Corps. Methods: Case control study enrolling 11,554 medical disability cases of U.S. enlisted Marines referred to the Physical Evaluation Board fiscal year 2001 to 2009 and 42,216 controls frequency matched to cases in a 4:1 ratio on year of accession into the service were analyzed utilizing bivariate and multivariate logistic regression analysis. Results: Increased age and body mass index at accession were associated with higher odds of medical disability. Females (odds ratio adjusted [ORadJ] = 1.3, 95% confidence interval [CI] = 1.2-1.3) have higher odds of disability than males. "Healthy Warrior Effect" was observed in that those who deployed (ORadi = 0.48, 95% Cl = 0.46-0.50) had decreased odds of medical disability than those who did not deploy. Medical waivers at accession (ORadi = 1.12, 95% Cl = 1.01-1.23) increased the odds of medical disability. Conclusions: Continued surveillance of the disability evaluation system is needed to help develop preventive measures and to help policy makers establish evidence-based policies on accession, deployment, and retention standards over the lifecycle of service members.