Background/Purpose: The purpose of this project was to describe Raynaud’s phenomenon (RP), very early diagnosis of systemic sclerosis (VEDOSS), and systemic sclerosis (SSc) in Veterans who were deployed in support of Post-9/11 operations.  We sought to describe the military occupation specialty, clinical features, and medication use across the three diagnoses. 

Methods: Individual Veterans medical records were assessed for RP (ICD-9 443.0), VEDOSS with swelling of hands (ICD-9 729.81) and RP (ICD-9 443.0), and SSc (ICD-9 710.1).  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 were used to compare frequency of these categorical variables. Logistic regression was used to assess the likelihood of characteristics of the three classifications of disease.

Results: In 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, VEDOSS and SSc cases were white males, but the likelihood of having RP, VEDOSS or SSc was higher in white females. The vast majority of RP, VEDOSS, and SSc cases were found in the Army service, with a rank of enlisted with the most common occupation specialties of electronic repair.   However, those in craftworks, engineering or maintenance,  and healthcare had a greater likelihood of RP. The use of vasodilators was low among RP, VEDOSS, and SSc. The most common comorbidities were pain and depression.  Gastrointestinal tract symptoms typical for SSc patients were found in RP patients.

Conclusion: This is a unique Veteran population of predominately-male patients. Our data suggests that vasodilator medications are potentially being under-utilized in this RP, VEDOSS, and SSc Veteran population.  Our data highlights mood and pain management is an important aspect of SSc care.

Socio-demographics of the study population

Clinical features of the study population

Logistic Regression Estimates for Demographic, Clinical Features and Military Occupation Characteristics Associated with Raynaud’s Phenomenon, Very Early Diagnosis of Systemic Sclerosis, and Systemic Sclerosis

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/raynauds-phenomenon-and-systemic-sclerosis-in-post-9-11-deployed-veterans-receiving-care-veterans-health-administration-care/