Sudden cardiac death associated with physical exertion in the US military, 2005-2010.

BACKGROUND: Sudden cardiac death associated with physical exertion (SCD/E) is a complicated pathophysiological event. This study aims to calculate the incidence rate of SCD/E in the US military population from 2005 to 2010, to characterise the demographic and cardiovascular risk profiles of decedents, and to evaluate aetiologies of and circumstances surrounding the deaths. METHODS: Perimortem and other relevant data were collected from the Armed Forces Medical Examiners Tracking System, Armed Forces Health Longitudinal Technology Application, and Defense Medical Epidemiology Database for decedents meeting SCD/E case definition. Incidence rates were calculated and compared using negative binomial regression. RESULTS: The incidence of SCD/E in the Active Component (ie, full-time active duty) US military from 2005 to 2010 was 1.63 per 100 000 person-years (py): 0.98 and 3.84 per 100 000 py in those aged <35 and ≥35 years, respectively. Atherosclerotic cardiovascular disease was the leading cause of death overall (55%) and in the ≥35-year age group (78%), whereas the leading cause of death in the <35-year age group (31%) could not be precisely determined and was termed idiopathic SCD/E (iSCD/E). SCD/E was more common in males than females (incidence rate ratio (IRR) = 5.28, 95% CI 2.16 to 12.93) and more common in blacks than whites (IRR=2.60, 95% CI 1.81 to 3.72). All female cases were black. CONCLUSIONS: From 2005 to 2010, the incidence of SCD/E in US military members aged <35 years was similar to most reported corresponding civilian SCD rates. However, the leading cause of death was iSCD/E and not cardiomyopathy. Improved surveillance and age-based prevention strategies may reduce these rates.

Quantification of the 5-year incidence of thromboembolic events in U.S. Air Force Academy cadets in comparison to the U.S. Naval and Military Academies.

The medical literature is replete with case reports of thromboembolic events related to high altitude exposure. Studies have shown an increased risk of thromboembolic events at high and very high altitudes. Most of these case reports and studies have been documented at altitudes between 3,000 m and 8,000 m (9,843-26,247 ft). The U.S. Air Force Academy (USAFA) rests at moderate altitude of 7,250 ft (2,210 m). This study was designed to quantify the incidence of thromboembolic events in USAFA cadets over a 5-year period and then compare the incidence of events to those in the age-matched, similarly screened midshipmen and cadet populations of the U.S. Naval and U.S. Military Academies living at sea level. Our study showed an increased incidence of thromboemoblic events in USAFA cadet outpatients compared with that in the U.S. Military Academy cadets and U.S. Naval Academy midshipmen. This implicates moderate altitude as a potential risk factor for thrombosis.

U.S. Armed Forces air crew: incident illness and injury diagnosis during the 12 months prior to retirement, 2003-2012.

U.S. Armed Services retirees are eligible for disability compensation for medical illness/injury incurred during their service. This analysis of recently retired U.S. active component air crew/aviation service members from all Services evaluated incident diagnoses among aviation retirees during the 12 months prior to retirement and assessed trends in first-time diagnoses by major diagnostic category and aviation component stratification. Most aviation retirees were in their 40s, Air Force, male, white, and senior officers and warrant officers. Among the study population, 14,191 (88%) of aviation retirees had at least one first-time diagnosis recorded during the 12 months prior to retirement. During 2003-2012, 63.8% of all diagnoses in aviation retirees during the 12 months prior to retirement were new. The highest proportions of new diagnoses were for "other disorders of the ear," "organic sleep disorders," and "general symptoms." Among the four subtypes of aviators, general air crew/air craft crew had the lowest proportion of new diagnoses (60.2%).