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Sequelae of Blast Events in Iraq and Afghanistan War Veterans using the Salisbury Blast Interview: A CENC Study.
Brain Injury ( IF 1.9 ) Pub Date : 2020-02-25 , DOI: 10.1080/02699052.2020.1729418
Jared A Rowland 1, 2, 3 , Sarah L Martindale 1, 2, 4 , Kayla M Spengler 1 , Robert D Shura 1, 2, 5 , Katherine H Taber 1, 2, 6, 7
Affiliation  

Objective: To comprehensively characterize blast exposure across the lifespan and relationship to TBI.Participants: Post-deployment veterans and service members (N = 287).Design: Prospective cohort recruitment.Main Measures: Salisbury Blast Interview (SBI).Results: 94.4% of participants reported at least one blast event, 75% reported a pressure gradient during a blast event. Participants reported an average of 337.7 (SD = 984.0) blast events (range 0-4857), 64.8% occurring during combat. Across participants, 19.7% reported experiencing a traumatic brain injury (TBI) during a blast event. Subjective ratings of blast characteristics (wind, debris, ground shaking, pressure, temperature, sound) were significantly higher when TBI was experienced and significantly lower when behind cover. Pressure had the strongest association with resulting TBI (AUC = 0.751). Pressure rating of 3 had the best sensitivity (.54)/specificity (.87) with TBI. Logistic regression demonstrated pressure, temperature and distance were the best predictors of TBI, and pressure was the best predictor of primary blast TBI.Conclusion: Results demonstrate the ubiquitous nature of blast events and provide insight into blast characteristics most associated with resulting TBI (pressure, temperature, distance). The SBI provides comprehensive characterization of blast events across the lifespan including the environment, protective factors, blast characteristics and estimates of distance and munition.

中文翻译:

使用索尔兹伯里爆炸采访的伊拉克和阿富汗战争退伍军人爆炸事件的后遗症:CENC 研究。

目的:全面描述整个生命周期的爆炸暴露以及与 TBI 的关系。参与者:部署后的退伍军人和服务人员(N = 287)。设计:前瞻性队列招募。主要措施:索尔兹伯里爆炸访谈(SBI)。结果:94.4%的参与者报告了至少一次爆炸事件,75% 的参与者报告了爆炸事件期间的压力梯度。参与者平均报告了 337.7 (SD = 984.0) 次爆炸事件(范围 0-4857),其中 64.8% 发生在战斗期间。在参与者中,19.7% 的人报告在爆炸事件中经历了创伤性脑损伤 (TBI)。爆炸特性(风、碎片、地面震动、压力、温度、声音)的主观评分在经历 TBI 时显着更高,而在掩护后则显着降低。压力与由此产生的 TBI 相关性最强(AUC = 0.751)。压力等级 3 对 TBI 具有最佳敏感性 (.54)/特异性 (.87)。Logistic 回归表明压力、温度和距离是 TBI 的最佳预测因子,而压力是原发性爆炸 TBI 的最佳预测因子。结论:结果证明了爆炸事件的普遍性,并提供了与 TBI 最相关的爆炸特征(压力、温度、距离)。SBI 提供了整个生命周期内爆炸事件的综合特征,包括环境、保护因素、爆炸特征以及距离和弹药的估计。温度和距离是 TBI 的最佳预测因子,压力是原发性爆炸 TBI 的最佳预测因子。结论:结果证明了爆炸事件的普遍性,并提供了对与 TBI 最相关的爆炸特征(压力、温度、距离)的洞察。SBI 提供了整个生命周期内爆炸事件的综合特征,包括环境、保护因素、爆炸特征以及距离和弹药的估计。温度和距离是 TBI 的最佳预测因子,压力是原发性爆炸 TBI 的最佳预测因子。结论:结果证明了爆炸事件的普遍性,并提供了对与 TBI 最相关的爆炸特征(压力、温度、距离)的洞察。SBI 提供了整个生命周期内爆炸事件的综合特征,包括环境、保护因素、爆炸特征以及距离和弹药的估计。
更新日期:2020-02-25
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