Comorbidity Correlates of Death Among New Veterans of Iraq and Afghanistan Deployment

Laurel A. Copeland, Erin Finley Garcia, Mary J. Bollinger, Megan E. Amuan, Mary Jo V Pugh

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

BACKGROUND:: Veterans of the wars in Iraq and Afghanistan who receive care in the Veterans Health Administration (VA) have high disease burden. Distinct comorbidity patterns have been shown to be differentially associated with adverse outcomes, including death. This study determined correlates of 5-year mortality. MATERIALS AND METHODS:: VA demographic, military, homelessness, and clinical measures informed this retrospective analysis. Previously constructed comorbidity classifications over 3 years of care were entered into a Cox proportional hazards model of death. RESULTS:: There were 164,933 veterans in the cohort, including African Americans (16%), Hispanics (11%), and whites (65%). Most were in their 20s at baseline (60%); 12% were women; 4% had attempted suicide; 4% had been homeless. Having clustered disorders of pain, posttraumatic stress disorder, and traumatic brain injury was associated with death [hazard ratio (HR)=2.0]. Mental disorders including substance abuse were similarly associated (HR=2.1). Prior suicide attempt (HR=2.2) or drug overdose (HR=3.0) considerably increased risk of death over 5 years. CONCLUSIONS:: As congressional actions such as Veterans Choice Act offer more avenues to seek care outside of VA, coordination of care, and suicide prevention outreach for recent veterans may require innovative approaches to preserve life.

Original languageEnglish (US)
JournalMedical Care
DOIs
StateAccepted/In press - Jun 30 2016

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Afghanistan
Iraq
Veterans
Veterans Health
United States Department of Veterans Affairs
Comorbidity
Suicide
Drug Overdose
Homeless Persons
Attempted Suicide
Somatoform Disorders
Post-Traumatic Stress Disorders
Hispanic Americans
Proportional Hazards Models
Mental Disorders
African Americans
Substance-Related Disorders
Demography
Mortality

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Copeland, L. A., Finley Garcia, E., Bollinger, M. J., Amuan, M. E., & Pugh, M. J. V. (Accepted/In press). Comorbidity Correlates of Death Among New Veterans of Iraq and Afghanistan Deployment. Medical Care. https://doi.org/10.1097/MLR.0000000000000588

Comorbidity Correlates of Death Among New Veterans of Iraq and Afghanistan Deployment. / Copeland, Laurel A.; Finley Garcia, Erin; Bollinger, Mary J.; Amuan, Megan E.; Pugh, Mary Jo V.

In: Medical Care, 30.06.2016.

Research output: Contribution to journalArticle

Copeland, Laurel A. ; Finley Garcia, Erin ; Bollinger, Mary J. ; Amuan, Megan E. ; Pugh, Mary Jo V. / Comorbidity Correlates of Death Among New Veterans of Iraq and Afghanistan Deployment. In: Medical Care. 2016.
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