Abstract

BackgroundWe describe Raynauds phenomenon (RP), potential very early diagnosis of systemic sclerosis (VEDOSS), and systemic sclerosis (SSc) in Veterans deployed in support of Post-9/11 operations. We sought to describe the military occupation specialty, clinical features, and vasodilator use across the three diagnoses.MethodsIndividual Veterans medical records were assessed for RP (ICD-9443.0), VEDOSS with swelling of hands (ICD-9729.81) and RP (ICD-9443.0), and SSc (ICD-9710.1). The distribution of sociodemographic, military service branch, job classification, vasodilator use, and comorbidities were examined across the three classifications of disease. The chi-squared test and Fisher’s exact compared frequency of these categorical variables. Logistic regression assessed the likelihood of characteristics of the three classifications.ResultsIn this population of 607,665 individual Veteran medical records, 857 had RP, 45 met possible VEDOSS criteria, and 71 had a diagnosis of SSc. The majority of RP, potential VEDOSS and SSc cases were white males. Those in craftworks, engineering or maintenance, and healthcare had a greater likelihood of RP. Less than half of RP and VEDOSS patients were on vasodilators. The most common comorbidities in this population were the diagnostic code for pain (highest in the potential VEDOSS group [81.6%]), followed by depression in all groups.ConclusionThis is a unique Veteran population of predominately-male patients. Our data suggests that vasodilator medications are potentially being under-utilized for RP and potential VEDOSS. Our data highlights mood and pain management as an important aspect of SSc care.

Highlights

  • We describe Raynauds phenomenon (RP), potential very early diagnosis of systemic sclerosis (VEDOSS), and systemic sclerosis (SSc) in Veterans deployed in support of Post-9/11 operations

  • After Institutional Review Board approval, we identified RP, potential VEDOSS, and SSc, in a cohort of Veterans who were evaluated for long-term outcomes of military exposures

  • The median age of patients with RP were under 29 years of age, where as potential VEDOSS and SSc patients were age 30–39

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Summary

Introduction

We describe Raynauds phenomenon (RP), potential very early diagnosis of systemic sclerosis (VEDOSS), and systemic sclerosis (SSc) in Veterans deployed in support of Post-9/11 operations. We sought to describe the military occupation specialty, clinical features, and vasodilator use across the three diagnoses. Raynaud’s phenomenon (RP) is a relatively common condition where vasospasm results in discoloration of the fingers and toes from white to blue and red [1]. Without other clinical symptoms, this condition is termed primary RP, and does not have severe consequences. Primary RP is most common in young women, may be familial and can remit over time [2]. In addition to behavioral measures, vasodilators are prescribed for management of secondary RP. In patients with RP, the presence of specific antibodies are strongly predictive of development of Systemic Sclerosis (SSc; scleroderma)

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