Chronic widespread pain in veterans of the first Gulf War: Impact of deployment status and associated health effects

JOURNAL OF PAIN

卷:8

Article

N-Hoffmant, Valerie L. Forma^1,2,3  Peloso, Paul M.⁴  Black, Donald W.⁵  Woolson, Robert F.⁶  Letuchy, Elena M.³  Doebbeling, Bradley N.^2,7,8,9 

[1] Iowa City Vet Affairs Med Ctr, Ctr Res Implementat Innovat Strategies Practice, Iowa City, IA USA

[2] Univ Iowa, Carver Col Med, Dept Internal Med, Iowa City, IA USA

[3] Univ Iowa, Coll Publ Hlth, Dept Epidemiol, Iowa City, IA USA

[4] Amgen Inc, Thousand Oaks, CA 91320 USA

[5] Univ Iowa, Carver Coll Med, Dept Psychiat, Iowa City, IA USA

[6] Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29425 USA

[7] Indiana Univ, Sch Med, Dept Internal Med, Indianapolis, IN USA

[8] Regenstrief Inst Inc, IU Sch Med, Indiana Univ Ctr Hlth Serv & Outcomes Res, Indianapolis, IN USA

[9] Roudebush VA Med Ctr, Ctr Implementing Evidence Based Practice, Hlth Serv Res Serv, Indianapolis, IN USA

关键词: chronic pain;    Gulf War;    veterans;    health care utilization;    health status;    comorbidity;   

DOI  :  10.1016/j.jpain.2007.07.003

来源: Elsevier

【 摘 要 】

Our study sought to 1) determine if deployment status is associated with chronic widespread pain (CWP), and 2) evaluate whether veterans with CWP have greater psychiatric comorbidity, higher health care utilization, and poorer health status than veterans without CWP. Five years after the conclusion of the first Gulf War (August 1990 to June 1991), we conducted a cross-sectional study of veterans who listed Iowa as the home of record using a stratified sampling design to determine their health status. We compared the prevalence of CWP between deployed and nondeployed veterans. Logistic and multiple linear regression models were constructed to test whether CWP was associated with comorbidities and health-related outcomes of interest. Five hundred ninety of 3695 veterans interviewed (16%) had CWP. Gulf deployment was associated with higher prevalence of CWP than deployment elsewhere (OR = 2.03, 95%Cl = 1.60-2.58), after adjustment. Both deployed and nondeployed veterans with CWP reported more health care utilization and comorbidities and lower health-related quality of life scores than veterans without CWP. Deployed veterans were more likely to have CWP than nondeployed veterans, and CWP was associated with poor health outcomes. Military and medical personnel should be aware that efforts to prevent, identify, and treat CWP in veterans returning from the current war may be needed. Perspective: This article indicates that deployed veterans may have an increased risk for development of CWP, which is associated with greater healthcare utilization and comorbidity and lower quality of life. The risk of poor health outcomes suggests that veterans returning from the present conflict should be screened for CWP on their return. (c) 2007 by the American Pain Society.

【 授权许可】

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