Health Phenotypes and Neurobehavioral Symptom Severity Among Post-9/11 Veterans With Mild Traumatic Brain Injury: A Chronic Effects of Neurotrauma Consortium Study.
Health Phenotypes and Neurobehavioral Symptom Severity Among Post-9/11 Veterans With Mild Traumatic Brain Injury: A Chronic Effects of Neurotrauma Consortium Study.
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DOI：
10.1097/htr.0000000000000574
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发表时间：
2021-01-01
影响因子：
2.4
通讯作者：
Pugh, Mary Jo
中科院分区：
文献类型：
--
作者：
Bouldin, Erin D.;Swan, Alicia A.;Norman, Rocio S.;Tate, David F.;Tumminello, Christa;Amuan, Megan E.;Eapen, Blessen C.;Wang, Chen-Pin;Trevino, Amira;Pugh, Mary Jo
关键词：
评估按健康特征分类的轻度创伤性脑损伤（mTBI）退伍军人组之间的神经行为症状是否存在差异。71，934名9/11事件后患有mTBI的退伍军人，来自神经创伤慢性效应联盟流行病学战士队列。回顾性队列的横断面分析。使用5年以上的健康和功能潜在类别分析确定的健康表型。使用神经行为症状量表测量症状严重程度;领域包括前庭、躯体、认知和情感。被归类为中度健康的退伍军人的症状负担最低，而多发性创伤表型组的症状负担最高。在考虑了社会人口统计学和损伤特征后，与中度健康的退伍军人相比，多发性创伤表型退伍军人在每个领域报告严重症状的几率约为三倍。那些最初健康状况中等但随着时间的推移健康状况下降的退伍军人出现严重症状的几率是一贯健康的退伍军人的两倍。最强的关联是在情感领域。与中度健康组相比，其他表型的退伍军人更有可能报告严重干扰其日常生活的症状（OR范围：1.3-2.8）。症状的严重程度和干扰因表型而异，包括健康状况稳定和下降的退伍军人之间。改善严重症状，特别是在情感领域，可以改善mTBI后的健康轨迹。
To evaluate whether neurobehavioral symptoms differ between groups of Veterans with mild traumatic brain injury (mTBI) classified by health characteristics. 71,934 post-9/11 Veterans with mTBI from the Chronic Effects of Neurotrauma Consortium Epidemiology Warfighter cohort. Cross-sectional analysis of retrospective cohort. Health phenotypes identified using latent class analysis of health and function over 5 years. Symptom severity measured using Neurobehavioral Symptom Inventory; domains included vestibular, somatic, cognitive, and affective. Veterans classified as Moderately Healthy had the lowest symptom burden while the Polytrauma Phenotype group had the highest. After accounting for sociodemographic and injury characteristics, Polytrauma Phenotype Veterans had about three times the odds of reporting severe symptoms in each domain compared to Moderately Healthy Veterans. Those Veterans who were initially Moderately Healthy but whose health declined over time had about twice the odds of severe symptoms as consistently healthier Veterans. The strongest associations were in the affective domain. Compared to the Moderately Healthy group, Veterans in other phenotypes were more likely to report symptoms substantially interfered with their daily lives (OR range: 1.3–2.8). Symptom severity and interference varied by phenotype, including between Veterans with stable and declining health. Ameliorating severe symptoms, particularly in the affective domain, could improve health trajectories following mTBI.