Research Highlights:
Embargoed until 4 a.m. CT/5 a.m. ET, Thursday, March 14, 2024
DALLAS, March 14, 2024 — After a stroke , African American veterans previously diagnosed with post-traumatic stress disorder (PTSD) were significantly more likely to be re-hospitalized than those without PTSD. PTSD did not raise the risk of post-stroke readmission in white veterans, according to research published today in Stroke , the peer-reviewed scientific journal of the American Stroke Association, a division of the American Heart Association.
“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,” said Chen Lin, M.D., M.B.A., senior author of the study, a staff neurologist at the Birmingham Veterans Administration (VA) Medical Center, and an associate professor of neurology at the University of Alabama at Birmingham.
PTSD is a mental health disorder that develops in some people who have experienced or witnessed a shocking, scary or dangerous event and leads to intense anxiety, flashbacks or other symptoms whenever events or situations trigger memories of the original trauma.
Previous studies have shown that people with PTSD have a higher risk of heart disease and stroke and they also develop stroke at younger ages than the general population. And while there have been other studies showing a higher risk of rehospitalization after stroke among Black adults this is the first study to analyze how PTSD affects outcomes after stroke, particularly the need for re-hospitalization.
“In those with PTSD, there are worse outcomes in general among African American veterans than white veterans. We looked at veterans with PTSD after they had a stroke. The main goal was to determine whether those with PTSD and stroke have different risks for stroke recurrence or hospital readmission, and also to see whether race affected readmission rates,” Lin said.
Using a Veterans Health Administration database, researchers analyzed African American and white veterans with stroke, comparing readmission rates in those with and without a PTSD diagnosis. Among the findings:
“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 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.
Study details:
The study is limited because it reviewed an administrative database of the Veterans Administration, so the findings may not be generalizable to civilians who may have PTSD for different reasons. The results may not be generalizable to female, Asian American or Native American veterans, who made up a very small percentage of the dataset of veterans with stroke in this study.
Co-authors, disclosures and funding sources are listed in the manuscript.
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Stroke
Association of Posttraumatic Stress Disorder and Race on Readmissions After Stroke
14-Mar-2024