Black veterans with PTSD may be at increased risk of readmission after stroke

Black veterans with post-traumatic stress disorder are more likely to be readmitted to the hospital after a stroke than white veterans or black veterans without PTSD, a new study finds.

the studyThe paper, which reviewed data from more than 93,000 veterans, was published Thursday in the American Heart Association's journal Stroke.

Previous research has shown that people with PTSD are at higher risk for heart disease and stroke, and that they develop strokes at a younger age than the general population. Studies have also shown that black adults have a higher risk of readmission after stroke. However, this is one of the first studies to analyze how her PTSD influences what happens after a stroke.

PTSD is a mental health disorder that affects people who have experienced a traumatic, frightening, or dangerous event. When an event or situation triggers a memory of the original trauma, it can cause intense anxiety, flashbacks, or other symptoms.

“We expected PTSD to be involved in all veterans, so we were surprised by the differences between African American and white veterans in both the impact of PTSD and other risk factors,” the study said. said Dr. Chen Lin, lead author of . In a news release.

Researchers used a Veterans Health Administration database to examine what happened to veterans with PTSD after they had a stroke. “The primary objective was to determine whether patients with PTSD and stroke have different risks for stroke recurrence and readmission, and to determine whether race is a different risk factor for recurrent stroke and readmission,” said Lin, a staff neurologist and associate professor at the Birmingham Veterans Administration Medical Center. “The idea was to see if it had an impact on hospitalization rates.” He received his doctorate in neurology from the University of Alabama at Birmingham.

The study used data from 93,651 veterans admitted to U.S. Veterans Affairs medical centers between 1999 and 2022 with a first stroke of any type. Their average age was just under 69 years old. Of those surveyed, 97% were male; 22% were black and 63% white. They were followed for an average of 5 years.

Nearly 17,000 stroke patients, or about 18% of veterans, were readmitted to VA hospitals for some reason. Almost 14% of stroke patients were diagnosed with his PTSD.

In their analysis, researchers looked at factors such as type 2 diabetes, high blood pressure, high cholesterol, and narrowing of the arteries outside the heart. Also considered were illicit drug or alcohol abuse, past heart attacks, and smoking history.

Black veterans with PTSD were found to have a 10% higher risk of readmission compared to veterans without PTSD. White veterans with PTSD had a 5% higher risk of readmission than veterans without PTSD.

“For people with PTSD, African American veterans generally have worse outcomes than white veterans,” Lin said.

Type 2 diabetes or illicit drug use was associated with increased risk of readmission after stroke among black veterans, but the same risk factors were not associated with readmission risk among white veterans.

High cholesterol was significantly associated with increased risk of readmission among white veterans, but not among black veterans.

High blood pressure, a previous heart attack, and narrowing of the arteries outside the heart increased the risk of readmission after a stroke for both black and white veterans.

“For both African Americans and whites, there are important health conditions that can impact the risk of readmission after stroke,” Lin said. “Post-discharge care after stroke is always a challenge. People find it difficult to get to the clinic, especially if their disability limits their ability to walk or drive. There is certainly a role for more targeted care.'' Factors such as type 2 diabetes and illicit drug use can be considered. ”

The study authors noted that their findings were limited by information in the VA database. The results also may not be generalizable to women, Asian Americans, or Native American veterans, who made up a small portion of the dataset of veterans who suffered a stroke in this study.

Lin said the study's results “help us focus on high-risk populations, reduce modifiable risk factors, achieve tighter type 2 diabetes management, and provide access to veterans who need prescription drug treatment.” “This highlights important things we can do to improve post-stroke care.” ”