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Análisis retrospectivo de los resultados a largo plazo después de la lesión de combate: un costo oculto de la guerra

Ian J Stewart1, Jonathan A Sosnov2, Jeffrey T Howard2

  • 1From the David Grant Medical Center, Travis AFB, CA (I.J.S.); Uniformed Services University of the Health Sciences, Bethesda, MD (I.J.S., J.A.S., B.D.M., K.K.C.); San Antonio Military Medical Center, TX (J.A.S., B.D.M.); U.S. Army Institute of Surgical Research, San Antonio, TX (J.T.H., J.A.O., K.K.C.); U.S. Air Force Center for Sustainment of Trauma and Readiness Skills, Baltimore, MD (R.F.); Oregon Health & Science University, Portland (D.H.Z.); South Texas Veterans Health Care System, San Antonio (M.B.); and Landstuhl Regional Medical Center, Landstuhl, Germany (C.T., B.A.F.). ian.stewart@us.af.mil.

Circulation
|December 2, 2015
PubMed
Resumen
Este resumen es generado por máquina.

Las lesiones de combate en los veteranos están relacionadas con problemas de salud a largo plazo. Las puntuaciones más altas de gravedad de la lesión se correlacionan con un mayor riesgo de hipertensión, enfermedad cardíaca, diabetes y enfermedad renal crónica.

Palabras clave:
Enfermedad coronariaEn el caso de la diabetes mellitushipertensiónel riñónla mortalidad

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Área de la Ciencia:

  • Medicina militar
  • Salud pública
  • Epidemiología

Sus antecedentes:

  • Más de 52.000 soldados estadounidenses resultaron heridos en los conflictos de Irak y Afganistán.
  • Las consecuencias a largo plazo de las lesiones de combate requieren un examen.
  • El estudio investiga los vínculos entre la gravedad de las lesiones de combate y las enfermedades crónicas.

Objetivo del estudio:

  • Determinar la asociación entre los marcadores de gravedad de las lesiones de combate y el posterior desarrollo de enfermedades crónicas.
  • Para analizar la incidencia de hipertensión, enfermedad arterial coronaria, diabetes mellitus y enfermedad renal crónica después de la lesión.
  • Cuantificar el riesgo de enfermedades crónicas basado en la gravedad de la lesión.

Principales métodos:

  • Estudio de cohorte retrospectivo de personal militar estadounidense gravemente herido (2002-2011).
  • Seguimiento hasta 2013, evaluando los resultados de las enfermedades crónicas utilizando los códigos de la CIE-9.
  • El análisis incluyó a 3846 sujetos después de las exclusiones por falta de datos o condiciones preexistentes.

Principales resultados:

  • Cada aumento de 5 puntos en la puntuación de gravedad de la lesión se relacionó con mayores tasas de incidencia de hipertensión (6%), enfermedad arterial coronaria (13%), diabetes mellitus (13%), y enfermedad renal crónica (15%).
  • La lesión renal aguda aumentó significativamente las tasas de hipertensión (66%) y las tasas de enfermedad renal crónica (casi 5 veces).

Conclusiones:

  • La gravedad de las lesiones de combate se asocia con el desarrollo de hipertensión, enfermedad arterial coronaria, diabetes mellitus y enfermedad renal crónica en veteranos.
  • Los hallazgos destacan la necesidad crítica de monitoreo y manejo a largo plazo de enfermedades crónicas en veteranos heridos en combate.