Prevalence and epidemiology of combat blast injuries from the military cohort 2001-2014

Accurate assessment of the incidence and prevalence of blast and non-blast-related injuries as well as their long-term outcomes is a critical first step in injury prevention, treatment, and health system resource management. The purpose of this report is to systematically review the literature on in...

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Bibliographic Details
Main Authors: Greer, Nancy L., Sayer, Nina (Author), Kramer, Mark A. (Author), Koeller, Eva (Author)
Corporate Authors: Minneapolis VA Health Care System (U.S.) VA Evidence Synthesis Program, Quality Enhancement Research Initiative (U.S.), United States Department of Veterans Affairs
Format: eBook
Language:English
Published: Washington, DC Department of Veterans Affairs, Health Services Research & Development Service 2016, February 2016
Series:Evidence-based synthesis program
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Collection: National Center for Biotechnology Information - Collection details see MPG.ReNa
Description
Summary:Accurate assessment of the incidence and prevalence of blast and non-blast-related injuries as well as their long-term outcomes is a critical first step in injury prevention, treatment, and health system resource management. The purpose of this report is to systematically review the literature on incidence and prevalence of combat blast injuries sustained during Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) 2001 through 2014 and the outcomes (eg., pain, vision loss, cognitive function, quality of life) following blast versus non-blast TBI.
Combat blast injuries are typically categorized by the mechanism of injury. Primary blast injuries result from the over-pressurization wave and typically affect gas-filled body structures (eg, lungs, gastrointestinal tract, middle ear) resulting in injuries such as blast lung, tympanic membrane rupture, abdominal hemorrhage, and concussion. Secondary blast injuries result from flying debris propelled by the blast wind and may affect any body part. Blunt force or penetrating injuries are possible. Tertiary blast injuries occur when the body is accelerated by the blast wind or pressure gradients. Any body part may be affected and typical injuries include fracture and traumatic amputation, closed and open brain injuries, and crush injuries. Quaternary blast injuries are due to other products of the explosion (eg., heat, light) and exposure to toxins and gases. Any body part may be affected and injuries include burns, blindness, and respiratory problems from inhaled toxic gases.
Quinary blast injuries include illnesses, injuries, and diseases resulting from post-explosion environmental contaminants (eg, bacteria, radiation). Factors such as type of explosive, distance from the explosion, and body orientation relative to the explosion influence the impact of the explosion on the body. Despite recognition of greater use of improvised and other explosive devices in the Afghanistan and Iraq War counter-insurgency operations relative to prior conflicts, the scientific literature regarding the incidence and prevalence of explosive device induced injuries is limited. Additionally, the consequences of experiencing a traumatic brain injury (TBI) related to blast exposure versus a TBI due to other mechanisms of injury (eg, motor vehicle accident, fall) may be different.
Physical Description:1 PDF file (iv, 115 pages) illustrations