Prognostic value of risk factors for different clinical presentations of upper gastrointestinal tract diseases in military personnel

BACKGROUND: The medical and social significance of upper gastrointestinal tract diseases is determined by their high prevalence and annual increase in morbidity. Military personnel have specific risk factors for the development of these pathologies that have not previously been studied in terms of their prognostic significance. AIM: Тo assess the role of various risk factors in the development of uncomplicated and complicated upper gastrointestinal tract pathology in military personnel participating and not participating in combat operations. METHODS: From February 2022 to December 2023, 256 military personnel aged 21 to 65 years with various mild surgical and therapeutic comorbidities and a significant gastrointestinal history were examined. All patients underwent esophagogastroduodenoscopy with testing for Helicobacter pylori. The analysis of the prevalence of gastrointestinal tract pathology was conducted in contingency tables based on morbidity data. The epidemiological significance of risk factors was evaluated by the attributable fraction (etiologic fraction), population attributable fraction, and attributable risk. RESULTS: The main group, which included military personnel participating in combat operations, consisted of 118 individuals, while the control group, which did not participate in combat operations, comprised 138. The prevalence of upper gastrointestinal tract pathology in combatants was characterized by acute erosive and ulcerativevlesions of the mucous membrane of the esophagus, stomach, and duodenum as well as chronic duodenal ulcers, which were observed primarily in career officers — 93 cases (79%) — and by delayed complications in contract servicemen (5%), manifested as gastrointestinal bleeding. in the group not participating in hostilities, the main findings were uncomplicated duodenal ulcer and acute erosions (29%). Assessment of the significance of risk factors using the attributable fraction (etiologic fraction) and population attributable fraction, in the combatant group revealed a predominance of modifiable risk factors over non-modifiable ones, with ratios of 1.6 and 2.1, respectively. CONCLUSION: The assessment of the role of various risks in the development of the studied upper gastrointestinal tract pathology in military personnel demonstrated the absence of dependence on the established traditional factors, with a predominance of modifiable risk factors (55.6%) due to their high prevalence. This finding has prognostic significance, since even a minor reduction in the prevalence of modifiable risk factors could lead to a significant population-level effect — a decrease in upper gastrointestinal tract diseases among military personnel.