Abstract 14864: Posttraumatic Stress Disorder and Mortality Among U.S. Army Veterans
Background: Posttraumatic stress disorder PTSD) has been associated with increased risk of multiple medical problems. This study investigates the mortality incidence of subjects with and without PTSD.
Methods: The study population consisted of 286,194 Veterans (age 63±18 years, 85.1% male). Electronic medical records were used to assess diagnoses and outcomes. Psychological health status (PTSD vs. Non-PTSD) was assessed. 637 subjects underwent coronary artery calcium (CAC) scanning. All-cause mortality was defined as hard end point. Multivariable Cox proportional hazards models were developed to predict all-cause mortality
Results: The prevalence of PTSD was 10.6% (30,460). During a mean follow-up of 116±24 months, the death rate was 13.2% in the overall population. The prevalence of PTSD in patients with and without hard end point was 28.9% and 8.1%, respectively. Risk-adjusted hazard ratio (HR) of all-cause mortality was 2.41 (95%CI 2.11-2.73, p=0.0001) for PTSD as compared to Non-PTSD cohort, and event free survival decreased from 88% in Non-PTSD to 79%in PTSD. The prevalence of CAC>0 was 59%% in non-PTSD vs. 76.1% in PTSD subjects (p=0.001). CAC was significantly higher in PTSD as compared to non-PTSD cohort (448±472 vs. 332±336, p=0.0001). The relative risk of death was 1.48 (95%CI 1.1-2.9, p=0.01) in PTSD subjects with CAC>0 as compared to non-PTSD subjects with CAC>0. (Figure)
Conclusion: The current study demonstrates that PTSD is associated with increased risk of death in Veterans. PTSD is associated with the presence and severity of atherosclerosis measured by CAC and predicts mortality independent of cardiovascular risk factors.
- © 2010 by American Heart Association, Inc.