TY  - JOUR
PY  - 2009//
TI  - A Systematic Review of Post-Deployment Injury-Related Mortality Among Military Personnel Deployed to Conflict Zones
JO  - BMC public health
A1  - Knapik, J. J.
A1  - Marin, Roberto E.
A1  - Grier, T. L.
A1  - Jones, Bruce H.
SP  - 231
EP  - 231
VL  - 9
IS  - 1
N2  - ABSTRACT: BACKGROUND: This paper reports on a systematic review of the literature on the post-conflict injury-related mortality of service members who deployed to conflict zones. METHODS: Literature databases, reference lists of articles, agencies, investigators, and other sources were examined to find studies comparing injury-related mortality of military veterans who had served in conflict zones with that of contemporary veterans who had not served in conflict zones. Injury-related mortality was defined as a cause of death indicated by International Classification of Diseases E-codes E800 to E999 (external causes) or subgroupings within this range of codes. RESULTS: Twenty studies met the review criteria; all involved veterans serving during either the Vietnam or Persian Gulf conflict. Meta-analysis indicated that, compared with non-conflict-zone veterans, injury-related mortality was elevated for veterans serving in Vietnam (summary mortality rate ratio (SMRR)=1.26, 95% confidence interval (95%CI)=1.08-1.46) during 9 to 18 years of follow-up. Similarly, injury-related mortality was elevated for veterans serving in the Persian Gulf War (SMRR=1.26, 95%CI=1.16-1.37) during 3 to 8 years of follow-up. Much of the excess mortality among conflict-zone veterans was associated with motor vehicle events. The excess mortality decreased over time. Hypotheses to account for the excess mortality in conflict-zone veterans included post-traumatic stress, coping behaviors such as substance abuse, ill-defined diseases and symptoms, lower survivability in injury events due to conflict-zone comorbidities, altered perceptions of risk, and/or selection processes leading to the deployment of individuals who were risk-takers. CONCLUSIONS: Further research on the etiology of the excess mortality in conflict-zone veterans is warranted to develop appropriate interventions.<p />  <p>Language: en</p>
LA  - en
SN  - 1471-2458
UR  - http://dx.doi.org/10.1186/1471-2458-9-231
ID  - ref1
ER  -