Data_Sheet_1_Characteristics and Impact of U.S. Military Blast-Related Mild Traumatic Brain Injury: A Systematic Review.PDF

As a result of armed conflict, head trauma from exposure to blasts is an increasing critical health issue, particularly among military service members. Whilst numerous studies examined the burden of blast-related brain injuries on service members', few systematic reviews have been published. This work provides a comprehensive summary of the evidence on blast-related mild traumatic brain injury (mTBI) burden in active U.S. military service members and inactive Veterans, describing characteristics and outcomes. Records published up to April 2017 were identified through a search of PubMed, Web of Science, Scopus, Ovid MEDLINE, and Cochrane Library. Records-based and original research reporting on U.S. military service members and Veterans with mild blast TBI were included. Data on subject characteristics, exposure, diagnostic criterion, and outcomes were extracted from included studies using a standardized extraction form and were presented narratively. Of the 2,290 references identified by the search, 106 studies with a total of 37,515 participants met inclusion criteria for blast-related mTBI. All but nine studies were based out of military or Veteran medical facilities. Unsurprisingly, men were over-represented (75–100%). The criteria used to define blast-related mTBI were consistent; however, the methodology used to ascertain whether individuals met those criteria for diagnosis were inconsistent. The diagnosis, most prevalent among the Army, heavily relied on self-reported histories. Commonly reported adverse outcomes included hearing disturbances and headaches. The most frequently associated comorbidities were post-traumatic stress disorder, depression, anxiety, sleep disorders, attention disorders, and cognitive disorders. The primary objective of this review was to provide a summary of descriptive data on blast-related mTBI in a U.S. military population. Low standardization of the methods for reaching diagnosis and problems in the study reporting emphasize the importance to collect high-quality data to fill knowledge gaps pertaining to blast-related mTBI.

受武装冲突影响，爆炸所致颅脑创伤已成为日益严峻的重大健康问题，在现役军人群体中尤为突出。尽管已有诸多研究探讨了爆炸相关颅脑损伤对军人的健康负担，但已发表的系统综述仍为数不多。本研究对美国现役军人及退役退伍军人的爆炸相关轻度创伤性脑损伤（mild traumatic brain injury, mTBI）健康负担相关证据进行了全面综述，并阐述了其特征与转归。本研究通过检索PubMed、Web of Science、Scopus、Ovid MEDLINE及Cochrane图书馆，筛选出截至2017年4月发表的相关文献。纳入针对美国军人及退伍军人的爆炸相关轻度创伤性脑损伤的记录类研究与原创研究。研究人员采用标准化提取表格从纳入的研究中提取研究对象特征、暴露史、诊断标准及转归相关数据，并以叙述性方式呈现结果。本次检索共识别出2290篇参考文献，其中106项涉及共37515名研究对象的研究符合爆炸相关轻度创伤性脑损伤的纳入标准。除9项研究外，其余研究均依托军事或退伍军人医疗设施开展。不出所料，男性占比过高（75%~100%）。用于定义爆炸相关轻度创伤性脑损伤的标准较为统一，但用于确认研究对象是否符合该诊断标准的方法却存在差异。该诊断在陆军中最为常见，且主要依赖研究对象的自我报告病史。常见的不良转归包括听力障碍与头痛。最常伴随的共病为创伤后应激障碍（post-traumatic stress disorder）、抑郁、焦虑、睡眠障碍、注意力障碍及认知障碍。本综述的主要目的是总结美国军人群体中爆炸相关轻度创伤性脑损伤的描述性数据。诊断方法标准化程度不足以及研究报告存在的各类问题，凸显了收集高质量数据以填补爆炸相关轻度创伤性脑损伤相关知识空白的重要性。