Table 2.
Hazard ratios for incident RA, according to self-reported trauma/PTSD categories in NHS II through 2011.
| PTSD and trauma status | |||||
|---|---|---|---|---|---|
| No trauma, no PTSD symptoms | Trauma, no PTSD symptoms | Trauma, 1–3 PTSD symptoms | Trauma, ≥4 PTSD symptoms | p for trenda | |
| Risk for RAb | |||||
| RA cases/person-years | 43/253,447 | 117/526,753 | 33/132,844 | 46/135,160 | |
| Age-adjusted HR (95% CI) | 1.00 (REF) | 1.25 (0.88, 1.78) | 1.32 (0.83, 2.07) | 1.76 (1.16, 2.67) | 0.01 |
| Multivariate-adjusted HR c (95% CI) | 1.00 (REF) | 1.25 (0.88, 1.78) | 1.31 (0.83, 2.07) | 1.76 (1.16, 2.67) | 0.01 |
| Multivariate-adjusted HR + smoking (95% CI) | 1.00 (REF) | 1.21 (0.85, 1.71) | 1.24 (0.78, 1.95) | 1.60 (1.05, 2.43) | 0.04 |
| Risk for seropositive RAd,e | |||||
| RA cases/person-years | 30/249,376 | 76/514,666 | 20/130,229 | 31/131,401 | |
| Age-adjusted HR (95% CI) | 1.00 (REF) | 1.16 (0.76, 1.77) | 1.14 (0.65, 2.01) | 1.69 (1.02, 2.80) | 0.04 |
| Multivariate-adjusted HR c (95% CI) | 1.00 (REF) | 1.16 (0.76, 1.77) | 1.13 (0.64, 2.00) | 1.68 (1.01, 2.79) | 0.05 |
| Multivariate-adjusted HR + smoking (95% CI) | 1.00 (REF) | 1.12 (0.73, 1.71) | 1.06 (0.60, 1.87) | 1.51 (0.91, 2.51) | 0.12 |
| Risk for seronegative RAe,f | |||||
| RA cases/person-years | 13/252,819 | 41/525,107 | 13/132,455 | 15/134,655 | |
| Age-adjusted HR (95% | 1.00 (REF) | 1.48 (0.79, 2.76) | 1.75 (0.81, 3.78) | 1.96 (0.93, 4.13) | 0.10 |
| Multivariate-adjusted HR b (95% CI) | 1.00 (REF) | 1.47 (0.79, 2.75) | 1.74 (0.80, 3.77) | 1.97 (0.93, 4.17) | 0.10 |
| Multivariate-adjusted HR + smoking (95% CI) | 1.00 (REF) | 1.45 (0.77, 2.71) | 1.69 (0.78, 3.67) | 1.85 (0.87, 3.92) | 0.14 |
P for trend was calculated based on the median values for each ordinal category
All-RA models: N = 49,693, including 239 cases; total person years = 1,048,205
Cox proportional hazards models, adjusted for age, questionnaire-year, race (Caucasian, non-Caucasian) and parental education (≤high school, > high school)
Seropositive RA models: N = 47,759, including 157 cases; total person years = 1,025,672
Heterogeneity: The p-value from a t-test comparing the models for association between PTSD and risk for seropositive RA vs. seronegative RA was 0.54
Seronegative RA models: N = 49,437, including 82 cases; total person years = 1,045,036 RA, rheumatoid arthritis; PTSD, post-traumatic stress disorder; NHSII, Nurses’ Health Study II; HR, hazard ratio; CI, confidence interval