Health conditions seen frequently in hospitalized United States Veterans who served after 9/11/2001: A scoping review

Background

Hospitalists working outside the Veterans Affairs (VA) system frequently will serve Veterans receiving care for acute conditions and/or awaiting transfer to VA facilities.

Objective

To perform a scoping review of health conditions and associated outcomes relevant to hospital medicine in US Veterans who served in active duty or reserve deployed roles after November 9, 2001.

Methods

A search of MEDLINE and Embase was performed using a combination of terms related to military service period and health conditions, yielding 5634 citations published after January 1, 2013.

Study Selection and Data Extraction

Two reviewers performed independent screening at the title/abstract and later at the full-text levels. Conflicts at both stages were resolved through discussion. Single reviewers extracted data and synthesized results into three categories: (1) mental health and nonblast trauma, (2) neurologic outcomes, and (3) other conditions, including cardiovascular and respiratory outcomes.

Results

Of 85 included studies, 19 focused on cardiovascular, respiratory, autoimmune, and multisystem outcomes; 38 focused on mental health and nonblast trauma; and 28 focused on traumatic brain injury and neurologic outcomes. Studies showed high rates of comorbid mental health diagnoses and suicide-related behaviors relative to non-Veteran populations, as well as relatively younger incidence of cardiovascular and respiratory chronic conditions, such as atrial fibrillation.

Conclusions

Most studied health conditions among Veterans of post-9/11 conflicts have focused on areas of particular importance to the VA. However, significant gaps remain, particularly in understanding the correlation between specific exposures and clinical outcomes currently observed and to be anticipated in the future in this population.