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- Title
Epilepsy Among Iraq and Afghanistan War Veterans - United States, 2002-2015.
- Authors
Pugh, Mary Jo; Van Cott, Anne C.; Amuan, Megan; Baca, Christine; Rutecki, Paul; Zack, Matthew M.; Kobau, Rosemarie
- Abstract
The age-adjusted prevalence of seizure disorder in United States veterans deployed in Iraq and Afghanistan conflicts (IAV) is 6.1 per 1,000 persons (1), compared with 7.1 to 10 per 1,000 persons in the general population (2,3). Persons with epilepsy are at risk of excess mortality in part because of comorbidity (4). Although patterns of comorbidity have been associated with mortality in IAV (5), the unique contribution of epilepsy to excess mortality in IAV is unknown. A cohort study was developed using inpatient, outpatient, and pharmacy data from the U.S. Department of Veterans Affairs, Veterans Health Administration (VA) to identify epilepsy, demographic characteristics, and baseline comorbidity for IAV who received VA care in 2010 and 2011. The VA's vital status records were used to identify 5-year mortality (2011-2015). The unadjusted Kaplan-Meier estimator and adjusted proportional hazards regression models tested the hypothesis that excess mortality is associated with epilepsy. IAV with epilepsy were more likely than those without epilepsy to have mental and physical comorbidity, and significantly higher mortality, even after controlling for demographic characteristics and other comorbid conditions (adjusted hazard ratio = 2.6; 95% confidence interval [CI] 2.1-3.2). IAV with epilepsy could benefit from evidence-based chronic disease self-management programs to reduce physical and psychiatric comorbidity, and linkages to VA clinical and other community health and social service providers.
- Subjects
UNITED States; EPILEPSY research; UNITED States. Dept. of Veterans Affairs; KAPLAN-Meier estimator; CHI-squared test; UNITED States. Veterans Health Administration; REGRESSION analysis; EPILEPSY; LONGITUDINAL method; VETERANS; COMORBIDITY; DISEASE prevalence
- Publication
MMWR: Morbidity & Mortality Weekly Report, 2016, Vol 65, Issue 44, p1224
- ISSN
0149-2195
- Publication type
journal article
- DOI
10.15585/mmwr.mm6544a5