PTSD tied to rehospitalization risk after first-time stroke among Black veterans
Click Here to Manage Email Alerts
Key takeaways:
- PTSD at the time of first stroke was associated with increased risk for rehospitalization among Black veterans.
- The elevated risk for rehospitalization was not observed among white veterans.
After first-time stroke, comorbid PTSD was associated with increased risk for hospital readmission among Black veterans that was not observed among white veterans, researchers reported.
In addition, the impact of significant risk factors for readmission such as hypertension and hyperlipidemia varied by race, according to study findings published in Stroke.
“Our findings highlight the important things we can do to improve post-stroke care, such as focusing on high-risk populations, reducing modifiable risk factors, achieving stricter type 2 diabetes control and access for veterans who may need prescription medication treatment,” Chen Lin, MD, MBA, staff neurologist at the Birmingham Veterans Affairs Medical Center and an associate professor of neurology at the University of Alabama at Birmingham, said in a press release.
To assess whether PTSD is associated with readmission after stroke and whether racial disparities were present, Lin and colleagues evaluated data from the VA Corporate Data Warehouse of all patients who received care for a first-time stroke in the Veterans Health Administration.
The cohort included 93,651 veterans with a first inpatient diagnosis of stroke from 1999 to Aug. 6, 2022 (97% men; 63% white).
Overall, 13.8% of the cohort had comorbid PTSD at the time of stroke, and 18% were readmitted for any cause to a VA hospital.
The comorbid presence of PTSD at the time of first stroke was associated with increased risk for hospital readmission among Black veterans (HR = 1.1; 95% CI, 1.02-1.19; P = .01), but the association was not significant among white veterans (HR = 1.05; 95% CI, 0.99-1.11; P = .09).
“We were expecting to see PTSD playing a role in all veterans, so we were surprised at the difference between African American and white veterans in both the impact of PTSD and other risk factors,” Lin said in the release.
Hypertension was associated with reduced risk for hospital readmissions in both Black (HR = 0.81; 95% CI, 0.74-0.89; P .01) and white veterans (HR = 0.89; 95% CI, 0.84-0.95; P .01), whereas only for white veterans was hyperlipidemia associated with a lower risk (HR = 0.92; 95% CI, 0.86-0.97; P .01), and only for black veterans was diabetes (HR = 1.13; 95% CI, 1.04-1.23; P .01) and drug abuse (HR = 1.22; 95% CI, 1.1-1.35; P .01) associated with increased risk.
“In both the African American and white populations, there are important health conditions that can play a role in the risk of readmission after a stroke. Post-discharge care after stroke is always a challenge — people find it hard to get to the clinic, especially if they have disabilities limiting their walking and driving ability. However, there is certainly a role for more targeted care focused on the modifiable risk factors, such as type 2 diabetes and illicit drug use,” Lin said.
Reference:
- African American veterans with PTSD had higher risk of re-hospitalization after stroke. https://newsroom.heart.org/news/african-american-veterans-with-ptsd-had-higher-risk-of-re-hospitalization-after-stroke. Published March 14, 2024. Accessed March 14, 2024.
Collapse
Click Here to Manage Email Alerts