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Investigators also found that African American and White veterans had different risk factors for re-hospitalization post-stroke.
African American veterans with post-traumatic stress disorder (PTSD) are more likely to be re-hospitalized with stroke compared to those without PTSD, according to a data published in Stroke. Further, investigators of the study found that PTSD did not contribute to post-stroke readmission for White veterans.1,2
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“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, a staff neurologist at the Birmingham Veterans Administration Medical Center and an associate professor of neurology at the University of Alabama at Birmingham, said in a press release.1
Investigators used the Veterans Health Administration database to analyze individuals with stroke and PTSD compared to those without PTSD. Data included 93,651 veterans aged 68.8 years on average, with 97% male and 22.4% African American. Individuals included were hospitalized at any Veterans Affairs medical center in the United States for a first stroke between 1999 and August 2022, according to the press release. Approximately 18% were readmitted to the hospital averaging a follow-up period of 5 years. Approximately 14% of patients also had PTSD.1
Data on risk factors, such as congestive heart failure, high blood pressure, high cholesterol, narrowing of the arteries outside of the heart, type 2 diabetes (T2D), illicit drug or alcohol abuse, previous heart attack, and history of smoking, were also included by the investigators.1
“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 press release.1
Investigators found that African American veterans with PTSD had a 10% greater risk of readmission compared to those without PTSD while White veterans only had a 5% greater risk of readmission compared to those without PTSD, according to the press release. Additionally, T2D or illicit drugs were significantly associated with higher risk of re-hospitalization among African American veterans but were not statistically significantly associated among White veterans. Congestive heart failure or high cholesterol were significantly associated with higher risk of re-hospitalization for White veterans, according to the press release.1
High blood pressure, a previous heart attack, and narrowing of arteries outside the heart were risk factors among both African American and White veterans, according to the results.1
The study was limited due to the review of an administrative database of veterans; therefore, the findings might not be generalizable to civilians with PTSD for various regions. Furthermore, the results are not generalizable to females, Asian American, or Native American veterans, according to the press release.1
“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 [T2D] and illicit drug use,” Lin said in the press release.1
