Black Veterans With PTSD and Stroke Have Higher Risk for Hospital Admissions

Compared with White veterans, Black veterans with a history of stroke and posttraumatic stress disorder (PTSD) have an increased risk for rehospitalization, according to study results published in Stroke journal.

Researchers aimed to study the risk for hospital readmission among patients with stroke with vs without PTSD, as well as the effect of race on readmission rates in this population.

Eligible participants were veterans receiving care at the Veterans Health Administration (VHA) with a history of stroke, identified by International Classification of Diseases (ICD) codes, from 1999 to 2022.

Overall, 93,651 patients (97.1% men; 62.89% White; 22.4% Black) with an inpatient stroke diagnosis were included in the analysis, of whom 12,916 (13.8%) also had PTSD and 16,896 (18.0%) were readmitted for any cause.

At study entry, 13.4% of White vs 18.4% of Black veterans had PTSD. Participants with vs without PTSD had a higher rate of comorbidities. Among Black veterans, 0.02% and 0.03% were rehospitalized per year of follow-up without and with PTSD, respectively. Among White veterans, 0.02% were rehospitalized per year of follow-up.

After adjustment and stratification by race, Black vs White veterans had a higher risk for readmissions (hazard ratio [HR], 1.17; 95% CI, 1.12-1.21; P <.01). In addition, factors such as age, myocardial infarction, diabetes, and peripheral vascular disease increased risk for readmissions (HRs, 1.01, 1.17, 1.06, and 1.16, respectively); however, the presence of hypertension and hyperlipidemia decreased risk for readmissions (HRs, 0.87 and 0.93, respectively).

A significant HR was noted between the Black race and PTSD (HR, 1.10; 95% CI, 1.02-1.18; P =.01), but not White race (HR, 1.05; 95% CI, 0.99-1.11; P =.10).

Limitations of the analysis were the retrospective design; the use of ICD codes vs clinical data to identify patients; and the underrepresentation of women and minority groups.

“Our results highlight an important area for potential improvement in future programs to assess and prevent readmissions for veterans with stroke both with and without PTSD in VHA hospitals,” the researchers concluded.

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of the author’s disclosures.