Citation

Rowland JA, Martindale SL, Spengler KM, Shura RD, Taber KH. Brain Inj. 2020; ePub(ePub): ePub.

Affiliation

Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.

Copyright

(Copyright © 2020, Informa - Taylor and Francis Group)

DOI

10.1080/02699052.2020.1729418

PMID

32096666

Abstract

Objective: To comprehensively characterize blast exposure across the lifespan and relationship to TBI.Participants: Post-deployment veterans and service members (N = 287).Design: Prospective cohort recruitment.Main Measures: Salisbury Blast Interview (SBI).Results: 94.4% of participants reported at least one blast event, 75% reported a pressure gradient during a blast event. Participants reported an average of 337.7 (SD = 984.0) blast events (range 0-4857), 64.8% occurring during combat. Across participants, 19.7% reported experiencing a traumatic brain injury (TBI) during a blast event. Subjective ratings of blast characteristics (wind, debris, ground shaking, pressure, temperature, sound) were significantly higher when TBI was experienced and significantly lower when behind cover. Pressure had the strongest association with resulting TBI (AUC = 0.751). Pressure rating of 3 had the best sensitivity (.54)/specificity (.87) with TBI. Logistic regression demonstrated pressure, temperature and distance were the best predictors of TBI, and pressure was the best predictor of primary blast TBI.Conclusion: Results demonstrate the ubiquitous nature of blast events and provide insight into blast characteristics most associated with resulting TBI (pressure, temperature, distance). The SBI provides comprehensive characterization of blast events across the lifespan including the environment, protective factors, blast characteristics and estimates of distance and munition.

Language: en

Keywords

Explosion; assessment; military; traumatic brain injury