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首页> 外文期刊>Military Medicine: Official Journal of AMSUS, The Society of the Federal Health Agencies >Comparison of Clinical Features in a Population of Basic Military Trainees Versus the General Department of Defense Beneficiary Population Presenting With Influenza
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Comparison of Clinical Features in a Population of Basic Military Trainees Versus the General Department of Defense Beneficiary Population Presenting With Influenza

机译：基本军事学员人口临床特征比较与甲型流感患有南防受益人人口总统

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Introduction: Upper respiratory tract infection (URI) is a well-documented cause of morbidity, extra expense, and lost training time among basic military trainees (BMTs). The goal of this study was to characterize the clinical presentation of influenza in the BMT population and to better understand how this presentation differs from that of the general Department of Defense (DoD) beneficiary population (non-BMTs). Materials and Methods: Clinical and demographic data were collected in a prospective study that enrolled DoD beneficiaries presenting to medical treatment facilities in San Antonio, Texas, with URI symptoms between January 2005 and March 2011. Vital signs and symptom duration were collected at the time of enrollment along with basic demographic information. Results: Among 4,448 participants enrolled, 466 (10.5%) tested positive for influenza: 198 of 3,103 BMTs (6.4%) vs. 268 of 1,345 non-BMTs (20%) (p 0.01); 412 of 466 had complete data for nine symptom-related variables. BMTs were more likely to be Caucasian males and younger than non-BMTs. BMTs had a higher temperature at the time of presentation (101.5 degrees F vs. 100.5 degrees F, p 0.01). BMTs presented less frequently than non-BMTs with chills (79.7% vs. 94.4%, p 0.01), malaise (62.1% vs. 87.0%, p 0.01), nausea (30.2% vs. 43.0%, p 0.01), and vomiting (12.1% vs. 21.7%, p = 0.01). Multiple logistic regression analysis showed that BMTs were less likely to have the four symptoms compared to non-BMTs even after controlling for gender and age (chills: odds ratio [OR] = 0.3, 95% confidence interval [CI] = 0.1-0.6, p 0.01; malaise: OR = 0.5, 95% CI = 0.3-0.8, p 0.01; nausea: OR = 0.5, 95% CI = 0.3-0.8, p 0.01; vomiting: OR = 0.4, 95% CI = 0.2-0.8, p 0.01). Although there was no difference in the frequency of subjective fever between the two groups, reported duration of fever was significantly shorter in BMTs than non-BMTs: median of 1 day (range 0-10) vs. 2 days (range 0-8) (p 0.01). BMTs presented with a composite symptom index mean of 6.2 (standard deviation = 1.4) symptoms, whereas non-BMTs presented with a mean of 6.9 (standard deviation = 1.3) symptoms (p 0.01). Conclusions: The pretest probability of a BMT presenting with URI symptoms having influenza is significantly lower than that for the general DoD beneficiary population. BMTs with influenza presented sooner, with higher fever, and with fewer overall symptoms than the general DoD beneficiary population. These differences are likely attributable to early reporting and response bias and less likely attributed to age. Military efforts to identify BMTs with suspected influenza infection early and to refer them for treatment promptly are efficacious.
机译：介绍：上呼吸道感染（URI）是一种记录的发病良好，额外费用，以及基础军事学员（BMTS）的培训时间。本研究的目的是表征博士人口流感的临床介绍，并更好地了解该介绍与国防部（国防部）受益人人口（非BMTS）的不同之处。材料和方法：临床和人口统计数据被收集在一项前瞻性研究中，注册DOD受益者在德克萨斯州圣安克西奥的医疗设施中，2005年1月至2011年3月之间的URI症状。在当时收集了生命体征和症状期限报名与基本人口统计信息一起。结果：参加4,448名参与者，466（10.5％）测试阳性的流感：198，共3,103 bmts（6.4％）与1,345个非BMT（20％）（P <0.01）; 412的466个有关9个与症状相关变量的完整数据。 BMTS更有可能是高加索男性和比非BMTS更年轻。 BMT在呈现时具有较高的温度（101.5度，vs.100.5 f，p <0.01）。 BMT呈不频繁地呈现，而不是寒冷的非BMTS（79.7％与94.4％，P＆ 0.01），恶果（62.1％与87.0％，P＆ 0.01），恶心（30.2％与43.0％，p＆lt。 ; 0.01），呕吐（12.1％vs.21.7％，p = 0.01）。多元逻辑回归分析表明，即使在控制性别和年龄（Chills：差距[或] = 0.3,95％置信区间[CI] = 0.1-0.6， P＆ 0.01;萎靡不振：或= 0.5,95％CI = 0.3-0.8，P <0.01; Nousea：OR = 0.5,95％CI = 0.3-0.8，P <0.01;呕吐：或= 0.4,95 ％CI = 0.2-0.8，P <0.01）。虽然两组之间的主观发烧的频率没有差异，但报告的发烧持续时间比非BMTS在BMTS中显着短：中位数为1天（范围0-10）与2天（范围0-8） （P <0.01）。患有6.2（标准偏差= 1.4）症状的复合症状指数均值的BMTS，而含有6.9（标准差= 1.3）症状的非BMT（标准偏差= 1.3）（P <0.01）。结论：具有甲型流感的URI症状的BMT的预测试概率明显低于国防部受益人人口的症状。 BMTS与流感较早呈现，发烧较高，总体症状较少，而不是国防部受益人人口。这些差异可能归因于早期报告和响应偏见，并且不太可能归因于年龄。在早期识别具有疑似流感感染的BMT的军事努力，并迅速地将其提及治疗是有效的。

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