207814 Risk of medically-treated injuries among Iraq and Afghanistan combat veterans

Wednesday, November 11, 2009: 8:45 AM

Kathleen F. Carlson, MS, PhD , Minneapolis VA Medical Center, Center for Chronic Disease Outcomes Research, Minneapolis, MN
Nina A. Sayer, PhD , Minneapolis VA Medical Center, Center for Chronic Disease Outcomes Research, Minneapolis, MN
Amy A. Gravely, MS , Minneapolis VA Medical Center, Center for Chronic Disease Outcomes Research, Minneapolis, MN
Siamak Noorbaloochi, PhD , Minneapolis VA Medical Center, Center for Chronic Disease Outcomes Research, Minneapolis, MN
Objective: Veterans have increased risk of injury after military discharge. We examined incidence of, and potential risk factors for, medically-treated injuries among Iraq and Afghanistan combat veterans enrolled in the Veteran's Affairs (VA) healthcare system.

Methods: We surveyed a national sample of combat veteran VA users in 2008. The sample was stratified by gender, race, and geographic region. We assessed mental, behavioral, and physical health using standard validated measures. Medically-treated injuries sustained after discharge were identified. Veterans' risk of injury was estimated in reference to demographics; overall physical/mental health status; probable traumatic brain injury, posttraumatic stress disorder (PTSD), and depression; and health behaviors. Stratified odds ratios (OR) and 95% confidence intervals (CI) were calculated using survey logistic regression. Directed acyclic graphs guided development of multivariate models. Results were adjusted for non-response and weighted to represent the target population.

Results: Of veterans contacted, 754 (62%) responded. Nearly half (47.3%; CI=42.0%-52.6%) reported sustaining at least one injury since discharge; there was no difference by gender. Increased odds of injury were associated with lower overall physical and mental health. Controlling for potential confounders, veterans with probable PTSD (OR=2.0; CI=1.2-3.3) and diagnosed depression (OR=2.6; CI=1.5-4.5) were more likely to have sustained an injury. Problem substance use was suggestive of increased risk (OR=1.6; CI=0.98-2.6).

Conclusions: Results suggest a large burden of injury among male and female Iraq and Afghanistan combat veteran VA users. Symptoms of PTSD and depression may be important indicators of increased risk. Further, longitudinal research examining these associations is warranted.

Learning Objectives:
1) Describe current knowledge of unintentional injury among combat veterans 2) Analyze incidence of medically-attended injury among Iraq and Afghanistan combat veterans receiving care through the Department of Veteranís Affairs (VA) healthcare system 3) Identify potential risk factors for medically-attended injury among Iraq and Afghanistan combat veteran VA users

Keywords: Veterans, Injury

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral-level injury prevention and control researcher working at a VA Medical Center
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.