Posttraumatic stress disorder and odds of major invasive procedures among US Veterans Affairs patients

作者：Greenawalt David Sloan^*; Copeland Laurel Anne; MacCarthy Andrea A; Sun Fangfang F; Zeber John Edward

来源：Journal of Psychosomatic Research, 2013, 75(4): 386-393.

DOI：10.1016/j.jpsychores.2013.08.012

• Posttraumatic stress disorder
• Depression
• Veterans
• Invasive procedures
• Surgery

Objectives: Although individuals with posttraumatic stress disorder (PTSD) are at heightened risk for several serious health conditions, research has not examined how having PTSD impacts receipt of invasive procedures that may alleviate these problems. We examined whether PTSD, after controlling for major depression, was associated with odds of receiving common types of major invasive procedures, and whether race, ethnicity, and gender was associated with odds of procedures.
Methods: Veterans Health Administration patients with PTSD and/or depression were age-matched with patients without these disorders. The odds of invasive hip/knee, digestive system, coronary artery bypass graft/percutaneous coronary intervention (CABG/PCI), and vascular procedures during FY2006-2009 were modeled for the full sample of 501,489 patients and for at-risk subsamples with medical conditions alleviated by the procedures examined.
Results: Adjusting for demographic covariates and medical comorbidity, PTSD without depression was associated with decreased odds of all types of procedures (odds ratios [OR] range 0.74-0.82), as was depression without PTSD (OR range 0.59-0.77). In analyses of at-risk patients, those with PTSD only were less likely to undergo hip/knee (OR = 0.78) and vascular procedures (OR = 0.73) but not CABG/PCI. African-Americans and women at-risk patients were less likely to undergo hip/knee, vascular, and CABG/PCI procedures (OR range 031-0.82).
Conclusion: With the exception of CABG/PCI among at-risk patients, Veterans with PTSD and/or depression were less likely to undergo all types of procedures examined. Future studies should examine the reasons for this disparity and whether it is associated with subsequent adverse outcomes. Published by Elsevier Inc.

• 出版日期2013-10