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Health Conditions Among Special Operations Forces Versus Conventional Military Service Members: A VA TBI Model
Amanda Garcia1, Tracy S Kretzmer, Kristen Dams-O'Connor
1Mental Health and Behavioral Sciences Section (MHBSS) (Drs Garcia, Kretzmer, Miles, Bajor, and Silva) and Physical Medicine & Rehabilitation Service (Dr Merritt), James A. Haley Veterans' Hospital, Tampa, Florida; Traumatic Brain Injury Center of Excellence (TBI CoE), Tampa, Florida (Dr Garcia); Departments of Neurology (Dr Dams-O'Connor) and Rehabilitation and Human Performance (Dr Dams-O'Connor), Icahn School of Medicine at Mount Sinai, New York City, New York; Departments of Psychiatry and Behavioral Neurosciences (Drs Miles, Bajor, Belanger, and Silva), Internal Medicine (Dr Silva), and Psychology (Dr Silva), University of South Florida, Tampa, Florida; Harvard Medical School, Boston, Massachusetts (Dr Bajor); Tampa VA Research and Education Foundation, Inc, Temple Terrace, Florida (Dr Tang); United States Special Operations Command (USSOCOM), Tampa, Florida (Dr Belanger); St Michael's Inc, Woodbridge, Virginia (Dr Belanger); VA Greater Los Angeles Healthcare System, Los Angeles, California (Dr Eapen); National Intrepid Center of Excellence (NICoE), Walter Reed National Military Medical Center (WRNMMC), Bethesda, Maryland (Dr McKenzie-Hartman); and F. Edward Hébert School of Medicine (SOM), Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland (Dr McKenzie-Hartman).
Objective:
To examine traumatic brain injury (TBI) characteristics and comorbid medical profiles of Special Operations Forces (SOF) Active Duty Service Member/Veterans (ADSM/Vs) and contrast them with conventional military personnel.
Setting:
The 5 Veterans Affairs (VA) Polytrauma Rehabilitation Centers.
Participants:
A subset of participants in the VA TBI Model Systems multicenter longitudinal study with known SOF status. These included 157 participants who identified as SOF personnel (average age = 41.8 years; 96% male, 81% active duty), and 365 who identified as Conventional Forces personnel (average age = 37.4 years; 92% male, 30% active duty).
Design:
Retrospective analysis of prospective cohort, cross-sectional.
Main Measures:
The Health Comorbidities Interview.
Results:
SOF personnel were more likely to have deployed to a combat zone, had more years of active duty service, and were more likely active duty at time of TBI. SOF personnel were more likely to have had mild TBI (vs moderate/severe) and their TBI caused by violent mechanism. SOF personnel had a higher number of comorbidities, with more diagnoses of chronic pain, osteoarthritis, hyperlipidemia, hip fractures, and obstructive sleep apnea.
Conclusion:
SOF personnel are at a higher risk for multimorbidity after TBI. Current rehabilitation practices should incorporate early screening and treatment of common conditions in this population, while future practices may benefit from a focus on prevention.
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