Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, Yale School of Medicine, Yale University, West Haven, Connecticut.
Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Healthcare System, Yale School of Medicine, Yale University, West Haven, Connecticut.
J Manipulative Physiol Ther. 2020 Oct;43(8):753-759. doi: 10.1016/j.jmpt.2019.10.016. Epub 2020 Jun 11.
Post-traumatic stress disorder (PTSD) is thought to complicate pain management outcomes, which is consistent with the impact of other psychosocial factors in the biopsychosocial model of pain. This study aimed to identify patient sociodemographic and clinical characteristics associated with PTSD prevalence among veterans of Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) who received Veterans Affairs (VA) chiropractic care.
A cross-sectional analysis of electronic health record data from a national cohort study of OEF/OIF/OND veterans with at least 1 visit to a VA chiropractic clinic from 2001 to 2014 was performed. The primary outcome measure was a prior PTSD diagnosis. Variables including sex, race, age, body mass index, pain intensity, alcohol and substance use disorders, and smoking status were examined in association with PTSD diagnosis using logistic regression.
We identified 14,025 OEF/OIF/OND veterans with at least 1 VA chiropractic visit, with a mean age of 38 years and 54.2% having a diagnosis of PTSD. Male sex (adjusted odds ratio [OR] = 1.23, 95% CI = 1.11-1.37), younger age (OR = 0.99, CI = 0.98-0.99), moderate-to-severe pain intensity (numerical rating scale ≥ 4) (OR = 1.72, CI = 1.59-1.87), body mass index ≥ 30 (OR = 1.34, CI = 1.24-1.45), current smoking (OR = 1.32, CI = 1.20-1.44), and having an alcohol or substance use disorder (OR = 4.51, CI = 4.01-5.08) were significantly associated with a higher likelihood of PTSD diagnosis.
Post-traumatic stress disorder is a common comorbidity among OEF/OIF/OND veterans receiving VA chiropractic care and is significantly associated with several patient characteristics. Recognition of these factors is important for the appropriate diagnosis and management of veterans with PTSD seeking chiropractic treatment for pain conditions.
创伤后应激障碍（PTSD）被认为会使疼痛管理的结果复杂化，这与疼痛的生物心理社会模型中其他社会心理因素的影响一致。本研究旨在确定与接受退伍军人事务部（VA）整脊治疗的持久自由/伊拉克自由/新黎明行动（OEF/OIF/OND）退伍军人中 PTSD 患病率相关的患者社会人口学和临床特征。
对 2001 年至 2014 年期间至少有一次 VA 整脊诊所就诊的 OEF/OIF/OND 退伍军人全国队列研究的电子健康记录数据进行了横断面分析。主要结局测量指标是先前的 PTSD 诊断。使用逻辑回归检查了包括性别、种族、年龄、体重指数、疼痛强度、酒精和物质使用障碍以及吸烟状况在内的变量与 PTSD 诊断的关联。
我们确定了 14025 名至少有一次 VA 整脊就诊的 OEF/OIF/OND 退伍军人，平均年龄为 38 岁，54.2%有 PTSD 诊断。男性（调整后的优势比[OR] = 1.23，95%可信区间[CI] = 1.11-1.37）、年龄较小（OR = 0.99，CI = 0.98-0.99）、中重度疼痛强度（数字评分量表≥4）（OR = 1.72，CI = 1.59-1.87）、体重指数≥30（OR = 1.34，CI = 1.24-1.45）、当前吸烟（OR = 1.32，CI = 1.20-1.44）和酒精或物质使用障碍（OR = 4.51，CI = 4.01-5.08）与 PTSD 诊断的可能性增加显著相关。
创伤后应激障碍是接受 VA 整脊治疗的 OEF/OIF/OND 退伍军人的常见共病，与多个患者特征显著相关。认识到这些因素对于适当诊断和管理寻求整脊治疗疼痛的 PTSD 退伍军人很重要。
