在9/11后的退伍军人中,明显的并发症现象与有关,与结果和死亡风险的分歧有关
Mary Jo Pugh1,2, Heidi Munger Clary3,4, Madeleine Myers1,2
1Informatics, Decision Enhancement, & Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, Utah, USA.
在患有的军人和退伍军人中发现了六种并发症表型. 这些模式影响死亡率,指导针对性干预措施,以更好地管理和并发症.
科学领域:
- 神经学与公共卫生
- 慢性疾病的流行病学.
- 军事和退伍军人的健康研究.
背景情况:
- 的诊断影响服务人员和退伍军人.
- 伴随性疾病显著影响健康轨迹和结果.
- 了解并发症模式对于有效的护理至关重要.
研究的目的:
- 在9/11事件后的服务成员和退伍军人中,在诊断之前和之后,识别不同的并发症现象型.
- 探索这些表型与死亡风险之间的关联.
- 为量身定制的临床干预和医疗保健系统改进提供信息.
主要方法:
- 在退伍军人卫生管理局内对服务人员和退伍军人的纵向队列研究 (2002-2018).
- 隐性类分析 (LCA) 来识别6种不同的并发症表型.
- 以特定原因的生存模型来分析到2021年的死亡率关联.
主要成果:
- 确定了六种表型:相对健康,PTSD,焦虑/抑郁,慢性疾病,双极性/物质使用障碍和多创伤.
- 事故,自杀/精神健康问题和癌症是导致死亡的主要原因.
- 每种表型都显示出与死亡率和特定死亡原因的独特关联.
结论:
- 划分并发症表型为个性化干预提供了一个框架.
- 支持综合护理模式来管理和并发症.
- 基于表型的向治疗可以减轻不良结果并改善患者的护理.
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