与战斗相关的创伤伤害及其严重程度与预测的心血管疾病风险之间的关系:ADVANCE队列研究
Christopher J Boos1,2,3,4, Usamah Haling5, Susie Schofield5
1Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre, Stanford Hall Estate, Near Loughborough, LE12 5QW, Nottinghamshire, UK. christopher.boos@uhd.nhs.uk.
遭受创伤的战斗退伍军人面临更高的预测心血管疾病 (CVD) 风险. 伤害严重程度的增加,包括截肢,与这种心血管疾病风险的增加独立相关.
科学领域:
- 军事医学 军事医学
- 心血管健康 心血管健康
- 创伤外科 手术 创伤外科
背景情况:
- 与战斗有关的创伤伤 (CRTI) 构成长期健康风险.
- 了解CRTI严重程度与心血管疾病 (CVD) 之间的联系对于退伍军人的医疗保健至关重要.
- 以前的研究还没有完全阐明CRTI与预测心血管疾病风险之间的关联.
研究的目的:
- 研究与战斗相关的创伤伤害 (CRTI) 和其严重程度之间的关系.
- 评估与未受伤同龄人相比,患有CRTI的战斗退伍军人预测的十年心血管疾病 (CVD) 风险.
- 确定伤害严重程度是否独立预测心血管疾病风险.
主要方法:
- 分析了ADVANCE队列研究数据,将579名受伤的退伍军人与565名无伤的对照进行了比较.
- 利用QRISK®3评分系统来计算10年内预测的心血管疾病风险 (心肌梗塞,中风,心血管疾病死亡).
- 使用新伤害严重性得分 (NISS) 量化伤害严重程度;根据年龄,性别和部署状态等混因素进行调整.
主要成果:
- 与没有受伤的对照相比,受伤的退伍军人表现出更高的精神疾病和勃起功能障碍率,以及更高的BMI.
- 预测的心血管疾病的相对风险在受伤群体中升高,特别是截肢者.
- CRTI和增加伤害严重程度 (更高的NISS,爆炸伤害,创伤性截肢) 独立地与更高的QRISK®3分数相关.
结论:
- 与战斗相关的创伤伤害独立地与预测的10年心血管疾病风险增加有关.
- CRTI的严重程度恶化,包括爆炸伤害和截肢,进一步提高了预测的心血管疾病风险.
- 这些发现凸显了对受创伤的战斗退伍军人进行长期心血管监测的重要性.
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