title: Prevalence of suicidality among Hispanic and African American veterans following surgery.
abstract: OBJECTIVE
  We evaluated factors associated with suicidal behavior and ideation (SBI) during 3 years of follow-up among 89,995 Veterans Health Administration (VHA) patients who underwent major surgery from October 2005 to September 2006.
  
  
  METHODS
  We analyzed administrative data using Cox proportional hazards models. SBI was ascertained by International Classification of Disease, 9th Revision codes.
  
  
  RESULTS
  African Americans (18% of sample; 16,252) were at an increased risk for SBI (hazard ratio [HR] = 1.21; 95% confidence interval [CI]  = 1.10, 1.32), whereas Hispanics were not (HR = 1.10; 95% CI = 0.95, 1.28). Other risk factors included schizophrenia, bipolar disorder, depression, posttraumatic stress disorder, pain disorders, postoperative new-onset depression, and postoperative complications; female gender and married status were protective against SBI.
  
  
  CONCLUSIONS
  The postoperative period might be a time of heightened risk for SBI among minority patients in the VHA. Tailored monitoring and postoperative management by minority status might be required to achieve care equity.
authors.affiliation: Laurel A. Copeland, Raphael T. McIntyre, Eileen M. Stock, and John E. Zeber are with the Center for Applied Health Research, Central Texas Veterans Health Care System jointly with Scott & White Healthcare, Temple. Daniel J. MacCarthy is with University of Texas Health Science Center, San Antonio. Mary Jo Pugh is with the South Texas Veterans Health Care System, San Antonio.
authors.forename: Laurel A
authors.initials: LA
authors.lastname: Copeland
authors.forename: Raphael T
authors.initials: RT
authors.lastname: McIntyre
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Stock
authors.forename: John E
authors.initials: JE
authors.lastname: Zeber
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: MacCarthy
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Pugh
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000208:ethnology; D008875:Middle Aged; D010146:Pain / Q000208:ethnology; D011183:Postoperative Complications / Q000208:ethnology* / Q000523:psychology; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000208:ethnology* / Q000523:psychology; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data*; D014728:Veterans; D058014:Veterans Health
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