Abstract
Primary objective: To characterize an acute stress reaction (ASR) following an improvised explosive device (IED) blast-related mild traumatic brain injury (mTBI).
Research design: Participants were male, US military personnel treated in Afghanistan within 4 days following an IED-related mTBI event (n = 239).
Methods and procedures: Demographics, diagnosis of ASR, injury history and self-reported mTBIs, blast exposures and psychological health histories were recorded.
Main outcomes and results: In total, 12.5% of patients met ASR criteria. Patients with ASR were significantly younger and junior in rank (p < 0.05). Patients with ASR were more likely to experience the IED-blast while dismounted, report a loss of consciousness (LOC) and higher pain levels (p < 0.05). Adjusting for age and rank, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.405; 95% CI = 1.105–1.786, p < 0.01). Adjusting for mechanism of injury (dismounted vs. mounted), LOC and pain, multivariate logistic regression showed an association between mTBI history and ASR (AOR = 1.453; 95% CI = 1.132–1.864, p < 0.01). Prior blast exposure and past psychological health issues were not associated with ASR.
Conclusions: A history of multiple mTBIs is associated with increased risk of ASR. Future research is warranted.
Acknowledgments
The authors would like to thank Dr Richard McCarron and Ms Alexis Gage for editorial review and Dr Ashraful Haque for feedback on earlier drafts of the manuscript.
Declaration of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
This report was supported by the Navy Bureau of Medicine and Surgery under Work Units No. N24LB. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense or the US Government. Approved for public release; distribution is unlimited. This research has been conducted in compliance with all applicable federal regulations governing the protection of human subjects in research (USAMRMC IRB Number M10166 and NMRC.2013.0003). CDR Labrie, LT Knox, LT Norris and LT Harris are military service members. This work was prepared as part of their official duties. Title 17 U.S.C. § 105 provides that ‘Copryight protection under this title is not available for any work of the United States Government’. Title 17 U.S.C. § 101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person's official duties.