title: Characterization of acute stress reaction following an IED blast-related mild traumatic brain injury.
abstract: OBJECTIVE
  To characterize an acute stress reaction (ASR) following an improvised explosive device (IED) blast-related mild traumatic brain injury (mTBI).
  
  
  METHODS
  Participants were male, US military personnel treated in Afghanistan within 4 days following an IED-related mTBI event (n = 239).
  
  
  METHODS
  Demographics, diagnosis of ASR, injury history and self-reported mTBIs, blast exposures and psychological health histories were recorded.
  
  
  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.
authors.affiliation: Neurotrauma Department, Naval Medical Research Center , Silver Spring, MD , USA .
authors.forename: Jacob N
authors.initials: JN
authors.lastname: Norris
authors.forename: Scottie
authors.initials: S
authors.lastname: Smith
authors.forename: Erica
authors.initials: E
authors.lastname: Harris
authors.forename: David Walter
authors.initials: DW
authors.lastname: Labrie
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Ahlers
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001753:Blast Injuries / Q000150:complications / Q000523:psychology*; D001924:Brain Concussion / Q000209:etiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology*; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D040701:Stress Disorders, Traumatic, Acute / Q000209:etiology / Q000523:psychology*; D014481:United States / Q000453:epidemiology
keywords: Acute stress reaction; blast; concussion; dismounted; military; multiple mTBIs; psychological health; traumatic brain injury