Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun:111:299-306.
doi: 10.1016/j.ypmed.2017.11.016. Epub 2017 Nov 17.

Medical-encounter mental health diagnoses, non-fatal injury and polypharmacy indicators of risk for accident death in the US Army enlisted soldiers, 2004-2009

Lisa Lewandowski-Romps  1 , Heather M Schroeder  2 , Patricia A Berglund  3 , Lisa J Colpe  4 , Kenneth Cox  5 , Keith Hauret  5 , Jeffrey D Hay  3 , Bruce Jones  5 , Roderick J A Little  3 , Colter Mitchell  3 , Michael Schoenbaum  6 , Paul Schulz  2 , Murray B Stein  7 , Robert J Ursano  8 , Steven G Heeringa  3 ; Army STARRS Collaborators
Affiliations

Medical-encounter mental health diagnoses, non-fatal injury and polypharmacy indicators of risk for accident death in the US Army enlisted soldiers, 2004-2009

Lisa Lewandowski-Romps et al. Prev Med. 2018 Jun.

Abstract

Accidents are a leading cause of deaths in U.S. active duty personnel. Understanding accident deaths during wartime could facilitate future operational planning and inform risk prevention efforts. This study expands prior research, identifying health risk factors associated with U.S. Army accident deaths during the Afghanistan and Iraq war. Military records for 2004-2009 enlisted, active duty, Regular Army soldiers were analyzed using logistic regression modeling to identify mental health, injury, and polypharmacy (multiple narcotic and/or psychotropic medications) predictors of accident deaths for current, previously, and never deployed groups. Deployed soldiers with anxiety diagnoses showed higher risk for accident deaths. Over half had anxiety diagnoses prior to being deployed, suggesting anticipatory anxiety or symptom recurrence may contribute to high risk. For previously deployed soldiers, traumatic brain injury (TBI) indicated higher risk. Two-thirds of these soldiers had first TBI medical-encounter while non-deployed, but mild, combat-related TBIs may have been undetected during deployments. Post-Traumatic Stress Disorder (PTSD) predicted higher risk for never deployed soldiers, as did polypharmacy which may relate to reasons for deployment ineligibility. Health risk predictors for Army accident deaths are identified and potential practice and policy implications discussed. Further research could test for replicability and expand models to include unobserved factors or modifiable mechanisms related to high risk. PTSD predicted high risk among those never deployed, suggesting importance of identification, treatment, and prevention of non-combat traumatic events. Finally, risk predictors overlapped with those identified for suicides, suggesting effective intervention might reduce both types of deaths.

Keywords: Accident death; Mental health; Military; Risk factors.

PubMed Disclaimer

References

    1. Adler DA, Possemato K, Mavandadi S, et al. , 2011. January Psychiatric status and work performance of veterans of operations enduring freedom and Iraqi freedom. Psychiatr. Serv 62 (1), 39–46. - PubMed
    1. American Academy of Sleep Medicine, 2005. International Classification of Sleep Disorders: Diagnostic and Coding Manual, 2nd ed American Academy of Sleep Medicine, Westchester, IL.
    1. Ames GM, Cunradi CB, 2004/2005. Alcohol use among young adults in the military: risk and prevention. Alcohol Res. Health 28 (4), 252–257.
    1. Armed Forces Health Surveillance Center, 2009. Deriving case counts from medical encounter data: considerations when interpreting health surveillance reports. Med. Surveill. Monthly Rep 16 (12), 2–8.
    1. Armed Forces Health Surveillance Center, 2013. July Summary of mental disorder hospitalizations, active and reserve components, US Armed Forces, 2000–2012. Med. Surveill. Monthly Rep 20 (7), 4–11. - PubMed