TABLE 3.
Risk of delayed‐onset trajectory according to frequency or severity of traumatic event(s). Adjusted OR with 95% CI
| Reference | Population | Trauma ascertainment | Exposure contrast | OR | 95%CI | Adjustment a |
|---|---|---|---|---|---|---|
| Dickstein 2010 (74) | Peacekeeping soldiers | Peacekeeping event scale | Combat exposure yes/no | No significant effect | NR | 4 |
| Karstoft 2013 (83) | Deployed soldiers with combat stress reaction | Perceived severity of battle, 4‐ point scale | Severity of battle vs none | 0.96 | 0.63–1.48 | Adjustment by latent class |
| Deployed soldiers without combat stress reaction | Perceived severity of battle, 4‐ point scale | Severity of battle vs none | 0.87 | 0.55–1.36 | Adjustment by latent class | |
| Deployed soldiers with combat stress reaction | Perceived combat life threat, 5 point scale | Level of threat | 1.90 | 1.08–3.35 | Adjustment by latent class | |
| Deployed soldiers without combat stress reaction | Perceived combat life threat, 5 point scale | Level of threat | 0.95 | (0.64–1.43) | Adjustment by latent class | |
| Lowe 2014 (85) | Urban residents | Telephone interview 20 item trauma questionnaire during life | Number of traumatic events | 1.13 | 1.04–1.22 | Adjustment for years since events |
| Bryant 2015 (73) | Injured patients | Records | Injury severity score 1–5 | No significant effect | NR | 5 |
| Maslow 2015 (87) | 9/11 rescue, recovery, and clean‐up workers | Telephone interview, ad hoc questionnaire on 7 traumatic exposures | Fear injured/killed yes/no b | 3.58 | 2.95–4.34 | 4 |
| Bromet 2016 (101) | 9/11 responders, police | Six items on WTC exposure severity | Intermediate (3–4) versus (0–2) | 2.8 | 1.4–5.6 | 5 |
| Six items on WTC exposure severity | High (5–6) versus low (0–2) | 4.8 | 2.4–9.8 | 5 | ||
| 9/11 responders, non‐traditional | Six items on WTC exposure severity | Intermediate (3–4) versus low (0–2) | 1.9 | 1.2–2.9 | 5 | |
| Six items on WTC exposure severity | High (5–6) versus low (0–2) | 3.4 | 1.9–6.2 | 5 | ||
| Eekhout 2016 (76) | Deployed soldiers | Deployment stressor list, 19 items | Level of deployment stressors | Significantly increased | NR | Adjustment? |
| Feder 2016 (70) | World Trade Center Police | World Trade Center exposure inventory, 10 items | Count of 10 exposures | 1.13 | 1.03–1.23 | Adjustment? |
| World Trade Center non‐traditional | World Trade Center exposure inventory, 10 items | Count of 10 exposures | 1.14 | 1.07–1.22 | Adjustment? | |
| (68)Welch 2016 (99) | Residents and area workers | Telephone interview, ad hoc questionnaire on 7 traumatic exposures | Threat 9/11 injury/death yes/no b | 1.44 | 1.21–1.71 | 5 |
| Donoho 2017 (75) | Deployed soldiers | Ad hoc 5 items | Combat exposure yes/no | No significant effect | NR | 6 |
| Polusny 2017 (94) | National Guard soldiers | Deployment risk and resilience Inventory | Combat exposure, scale? | 1.07 | 1.02–1.12 | Adjustment? |
| Palmer 2019 (92) | Deployed soldiers | Records on parent unit equivalent with role in combat | Combat role versus support role | 3.13 | 1.85–5.26 | 3 |
| Lowe 2020(68) | Injured patients | Records | Exposed to assault versus motor vehicle accident | 2.67 | 1.32–5.4 | 4 |
NR, not reported; NS: p> 0.05.
a
Number of determinants adjusted for by analysis or design from the following list of 6 categories of established potential confounders: sex, age, socio‐economic position, previous mental health, previous somatic health, childhood abuse.
b
Five other 9/11 trauma direct and indirect trauma exposure indices were all significantly related to the delayed‐onset trajectory.