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from Medscape
http://www.medscape.com/viewarticle/710808?src=mpnews&spon=12&uac=89474MT

Veterans With PTSD Twice As Likely to Die After Surgery
Janis C. Kelly
October 17, 2009

POST TRAUMATIC STRESS DISORDER
a psychiatric dx that may now be seen as a marker for cardiovascular disease
= significant and independent risk factor in this study

MAJOR INCREASE IN MORTALITY
2x more likely to die
25% increase in 1-year mortality
1-year mortality 8.5% in vets w/ PTSD, 6.8% in vets w/O PTSD
2.2X high odds of death within 1 year for vet with PTSD
odds ratio higher than that for diabetes (1.68)
regardless of how many years post-military service

STUDY
1st study on question PTSD effect on mortality after surgery
study presented October 17 at American Soc of Anesthesiologists 2009 Annual Meeting
lead author Marek Brzezinski, MD, PhD, from San Francisco Vet Affairs Med Ctr & U.CA.SF
controlled for age, preexisting conditions incl CV dz, HTN, DM, high chol, smoking, depression
data used: 1998-2008
n=1792 male vets seeking elective surgery requiring admission at SFVA hopsital
129 had established PTSD dx at admission (7.8%)
these PTSD pts were on average 7 years younger than the non-PTSD pts (59 vs 66 years)
PTSD pts had significantly increased prevalence of postoperative complications, esp:
delirium, acute respiratory failure
also PTSD pts have more cardiac risk factors

ONGOING RESEARCH
San Francisco research group
prospective epidemiological study on effects of PTSD on perioperative outcomes
in the works: potential protective effects of medical therapy

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