Miller Robert, Nemeth Attila, Taggart J Luke, Hall Mary Ann Kirkconnell, Akwe Joyce
New Orleans VA Medical Center, New Orleans, LA, USA.
Tulane University Medical School, New Orleans, LA, USA.
J Gen Intern Med. 2025 May 15. doi: 10.1007/s11606-025-09601-8.
Recent legislation, the MISSION Act and the PACT Act, expanded access to and utilization of non-Department of Veterans Affairs (VA) health care; more Veterans now receive care from non-VA healthcare providers. Hospitalists outside the VA may be less familiar with Veterans' service-related exposures and presumptive service-related conditions. We aimed to summarize research findings on service-related exposures and conditions among Vietnam War Veterans.
Using Arksey and O'Malley's methodological framework for scoping reviews, we searched PubMed, EMBASE, and Web of Science databases in June 2023. References were imported into EndNote and screened using Covidence collaborative review software. Two reviewers assessed eligibility, with disagreements resolved by a third, then one extracted data. We included papers published in 1998 or later focused on US Vietnam Veterans, excluding genetic/modeling studies, study protocols, case reports/series, clinical trials, and papers without relevance to hospital medicine.
We identified 1185 papers; 251 were duplicates, 450 were excluded through title/abstract review, and 335 were excluded after full-text review. A total of 149 studies were included. The exposures mentioned most frequently were Agent Orange/unspecified herbicides (n = 55), violence/combat (n = 14), and infectious disease (n = 9). The most common conditions were PTSD (n = 39), neuropsychiatric conditions (n = 35), cancer (n = 19), metabolic/endocrine disease (n = 11), and neurological dysfunction (n = 11). Overall mortality was addressed in 13 studies.
The current literature highlights numerous service-related exposures and conditions recognized by the VA, which may assist hospitalists caring for Vietnam Veterans outside the VA.
近期的立法，即《使命法案》和《PACT法案》，扩大了非退伍军人事务部（VA）医疗保健的获取和使用范围；现在有更多退伍军人接受非VA医疗保健提供者的治疗。VA以外的住院医师可能对退伍军人与服役相关的接触和推定的与服役相关的疾病不太熟悉。我们旨在总结关于越战退伍军人与服役相关的接触和疾病的研究结果。
我们使用阿克斯和奥马利的范围综述方法框架，于2023年6月搜索了PubMed、EMBASE和科学网数据库。参考文献被导入EndNote并使用Covidence协作综述软件进行筛选。两名评审员评估入选资格，如有分歧则由第三名评审员解决，然后由一名评审员提取数据。我们纳入了1998年或之后发表的、关注美国越战退伍军人的论文，不包括基因/建模研究、研究方案、病例报告/系列、临床试验以及与医院医学无关的论文。
我们识别出1185篇论文；251篇为重复论文，450篇通过标题/摘要评审被排除，335篇在全文评审后被排除。总共纳入了149项研究。提及最频繁的接触因素是橙剂/未指明的除草剂（n = 55）、暴力/战斗（n = 14）和传染病（n = 9）。最常见的疾病是创伤后应激障碍（PTSD，n = 39）、神经精神疾病（n = 35）、癌症（n = 19）、代谢/内分泌疾病（n = 11）和神经功能障碍（n = 11）。13项研究涉及总体死亡率。
当前文献突出了VA认可的众多与服役相关的接触因素和疾病，这可能有助于在VA以外照顾越战退伍军人的住院医师。
