title: A comparison of the postdeployment hospitalization experience of U.S. military personnel following service in the 1991 Gulf War, Southwest Asia after the Gulf War, and Bosnia.
abstract: Much attention has been given to the impact of deployment on the health of veterans from the 1991 Gulf War. Whereas increases in self-reported symptoms have been common, no specific exposures have been implicated. Some have suggested that stress from deployment is the chief cause for multisymptom conditions among Gulf War veterans, but comparisons with the health of other recent deployers have not been made. We sought to examine the impact of several large military deployments on hospitalization experience. Hospitalization records were examined for all active duty personnel deployed exclusively to the Gulf War, Southwest Asia after the Gulf War, or Bosnia. Cox's hazard modeling was used to assess time until first post-deployment hospitalization, separation from active duty, or December 31, 2000, whichever occurred first, while controlling for influential covariates and temporal changes. Personnel deployed to Southwest Asia after the 1991 Gulf War were at a slight increased risk for any-cause hospitalization and for 3 of the 14 major diagnostic categories when compared with veterans of the 1991 Gulf War. Personnel deployed to Bosnia were at a decreased risk for any-cause hospitalization and 12 of the 14 major diagnostic categories when compared with Gulf War veterans. These findings do not fully explain the complexity of postdeployment health experiences. Although the risk for hospitalization may be associated with regional deployment, it is unlikely that Gulf War veterans are at greater risk of hospitalization due to a specific exposure-related disease.
authors.affiliation: Department of Defense Center for Deployment Health Research at the Naval Health Research Center, San Diego, California 92186-5122, USA. besa@nhrc.navy.mil
authors.forename: Besa
authors.initials: B
authors.lastname: Smith
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Smith
authors.forename: Margaret A K
authors.initials: MA
authors.lastname: Ryan
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Gray
mesh_terms: D000293:Adolescent; D000328:Adult; D001208:Asia; D017522:Bosnia and Herzegovina; D016001:Confidence Intervals; D047830:Gulf War; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D014481:United States