TABLE 6-13 Suicide and Accidental Death

Reference

Study Design

Population

Outcomes

Results

Adjustments

Comments

CDC 1987

Retrospective cohort, mortality, prevalence

9324 Vietnam-theater veterans, 8989 Vietnam-era veterans who entered Army in 1965-1971

Follow-up began at date of discharge, ended at death or December 31, 1983, whichever came first; mortality data from death certificates coded by ICD-9 and blind to Vietnam status; review panel of two physicians reviewed cause of death, using medical and legal records for each of 426 deaths; all causes of death were coded by ICD-9 and blind to Vietnam status

Mortality 17% higher in theater than era; all deaths ≤ 5 years rate ratio 1.45, 95% CI 1.08-1.96, > 5 years rate ratio 1.01, 95% CI 0.79-1.28; all external causes rate ratio 1.25, 95% CI 1.00-1.55; death from motor-vehicle accidents ≤ 5 years rate ratio 1.93, 95% CI 1.16-3.22), > 5 years rate ratio 1.16, 0.72-1.87; suicide ≤ 5 years rate ratio 1.72, 95% CI 0.76-3.88 (adjusted for covariates based on death certificates risk ratio 2.59, 95% CI 1.09-6.17 or medical review panel risk ratio 2.56, 95% CI 1.11-5.87), > 5 years rate ratio 0.64, 95% CI 0.32-1.30; homicide ≤ 5 years rate ratio 1.52, 95% CI 0.59-3.91, > 5 years rate ratio 0.78, 95% CI 0.39-1.55; accidental poisoning (mostly drugs) ≤ 5 years rate ratio 1.69, 95% CI 0.49-5.77

Unadjusted

 

VES

 

Boehmer et al. 2004

Cohort, mortality 30 years after war

9324 Vietnam-theater veterans, 8989 Vietnam-era veterans

Vital-status and cause-of-death followup using VA BIRLS, SSA, and NDI Plus databases; mortality data from death certificates; causes of death coded by ICD-9 and ICD-10 and blind to deployment status

All external causes ≤ 5 years rate ratio 1.62, 95% CI 1.16-2.26, > 5 years rate ratio 1.08, 95% CI 0.89-1.29; motor-vehicle accidents ≤ 5 years rate ratio 1.93, 95% CI 1.16-3.22, > 5 years rate ratio 1.02, 95% CI 0.73-1.43; suicide ≤ 5 years rate ratio 1.72, 95% CI 0.76-3.88, > 5 years rate ratio 0.93, 95% CI 0.64-1.34; accidental poisoning (mostly drugs) ≤ 5 years rate ratio 1.69, 95% CI 0.50-5.77, > 5 years rate ratio 2.58, 95% CI 1.09-6.14; homicide ≤ 5 years rate ratio 1.52, 95% CI 0.59-3.91, > 5 years rate ratio 0.80, 95% CI 0.50-1.26; undetermined intent > 5 years rate ratio 3.19, 95% CI 0.88-11.58

Crude death rate per 100,000 person-years

Used multiple sources for vital-status ascertainment; death certificates may not be accurate as to cause of death, particularly suicide; long followup after Vietnam war; large number of deaths

(Derived from VES)



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