Dept. of Public Health and Preventive Medicine
Oregon Health & Science University
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.
School of Medicine
Fernandez, Aisling Gardner, "Historical Cohort Study of Posttramatic Stress Disorder (PTSD) and the Risk of Motor Vehicle Crash Hospitalization Among Recent Veterans Enrolled in Veterans Administration Healthcare" (2013). Scholar Archive. 3478.