Racial and Ethnic Differences in Deaths by Suicide, Drug Overdose, and Opioid-Related Overdose in a National Sample of Military Members With Mild Traumatic Brain Injury, 1999-2019.
Racial and Ethnic Differences in Deaths by Suicide, Drug Overdose, and Opioid-Related Overdose in a National Sample of Military Members With Mild Traumatic Brain Injury, 1999-2019.
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DOI：
10.1097/htr.0000000000000829
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发表时间：
2023-03-01
影响因子：
2.4
通讯作者：
Brenner, Lisa A.
中科院分区：
文献类型：
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作者：
Bahraini, Nazanin;Adams, Rachel Sayko;Caban, Jesus;Kinney, Adam R.;Forster, Jeri E.;Hoffmire, Claire A.;Monteith, Lindsey L.;Brenner, Lisa A.
目的：研究在军队服役期间被诊断为轻度创伤性脑损伤(MTBI)的军人中，与自杀和药物和阿片类药物有关的过量死亡的种族和民族差异。1999年至2019年期间在军事卫生系统(MHS)接受护理的军事人员的回顾队列。总共有356,514名18岁至的军人，他们在1999年至2019年期间在现役或现役期间接受了脑外伤的诊断，作为脑外伤的指标。使用国家死亡指数中的ICD-10代码识别自杀死亡、药物过量死亡和阿片类药物过量死亡。种族和民族是从MHS数据存储库中获取的。总体粗率为自杀38.67/10万人年，药物过量死亡31.01/10万人年，阿片类药物过量死亡20.82/10万人年。在所有三种死亡结果中，自认为是其他人的军人的粗率和特定年龄的比率都高于所有其他种族/族裔群体。经年龄调整后，被归类为其他种族/族裔群体的自杀率在自杀方面是其他种族/族裔群体的5倍，在药物和阿片类药物过量死亡方面分别是其他种族/族裔群体的11倍和3.5倍。这些发现扩展了先前关于mTBI患者中自杀和药物过量死亡风险的知识，并突出了理解种族和民族对死亡率影响的新的重要领域。必须解决关于种族和民族分类的方法限制，以确保未来的研究更好地了解患有脑外伤的军人自杀和吸毒过量死亡率方面的种族和民族差异。
To examine racial and ethnic differences in suicide and drug and opioid related overdose deaths among a population-based cohort of military service members who were diagnosed with a mild traumatic brain injury (mTBI) during military service. Retrospective Cohort Military personnel receiving care within the Military Health System (MHS) between 1999–2019. In total, 356,514 military members aged 18–64, who received a mTBI diagnosis as their index TBI between 1999–2019, while active duty or activated. Death by suicide, death by drug overdose and death by opioid overdose were identified using ICD-10 codes within the National Death Index. Race and ethnicity were captured from the MHS Data Repository. Overall crude rates were 38.67 per 100,000 person-years for suicide; 31.01 per 100,000 person-years for drug overdose death; and 20.82 per 100,000 person-years for opioid overdose death. Crude and age-specific rates for military members who self-identified as Other were higher than all other racial/ethnic groups for all three mortality outcomes. Adjusting for age, suicide rates for those classified as Other were up to 5 times that of other racial/ethnic groups for suicide, and up to 11 and 3.5 times that of other race/ethnicity groups for drug and opioid overdose death, respectively. Findings extend previous knowledge regarding risk for suicide and deaths by drug overdose among those with mTBI and highlight new important areas for understanding the impact of race and ethnicity on mortality. Methodological limitations regarding classification of race and ethnicity must be addressed to ensure that future research provides a better understanding of racial and ethnic disparities in suicide and drug overdose mortality among military members with TBI.