Date

Fall 2013

Document Type

Thesis

Degree Name

M.P.H.

Department

Dept. of Public Health and Preventive Medicine

Institution

Oregon Health & Science University

Abstract

Combat Veterans have an increased risk of motor vehicle crash (MVC)-related death compared to non-combat Veterans. We examined whether posttraumatic stress disorder (PTSD) was associated with hospitalizations for MVC-related injuries in Iraq and Afghanistan War Veterans who use Veterans Health Administration (VHA) healthcare. We conducted a historical cohort study using VHA medical records for 119,343 Veterans who enrolled in VHA healthcare within a year of deployment and who used VA healthcare services consistently for five years. We used univariate and multivariate generalized linear models to estimate the five-year relative risk (RR) of MVC-related hospitalization among Veterans who were diagnosed with PTSD within the first year post-deployment versus those who were not. PTSD exposure was defined as one or more inpatient stays or two or more outpatient encounters where the Veteran was given a code for PTSD (ICD-9 code: 309.81). Multivariate models adjusted for age, gender, race/ethnicity, education, marital status, military branch, military component, number of deployments, distance to the nearest VA, and service connection status. Three hundred seventy-three of 119,343 Veterans were hospitalized for MVC-related injuries within five years of deployment; typically they were male (87%) and 18-24 years old (33%). Compared to Veterans not given PTSD diagnoses, those diagnosed with PTSD were 40% more likely to be hospitalized for MVC-related injuries (RR=1.4; 95% CI=1.1 to 1.7). However, after adjustment for potential confounders, Veterans diagnosed with PTSD had no greater risk than those without a diagnosis (RR=1.0; 95% CI=0.8 to 1.2). Therefore, PTSD appears to be an indicator rather than a causal factor for increased risk of MVC among post-deployment Veterans. The findings of our historical cohort study vi confirm that combat Veterans with a PTSD diagnosis within a year of deployment have an increased risk of hospitalization due to motor vehicle crash (MVC)-related injury within five years of deployment compared to Veterans not given a PTSD diagnosis. Additional research is needed to disentangle these complex relationships, and to explore risk factors for all MVCs among all Veterans.

Identifier

doi:10.6083/M4WH2N9Q

School

School of Medicine

Included in

Public Health Commons

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