`Post-traumatic stress disorder (PTSD) is estimated to affect 15 to 31% of Vietnam veterans and 20% of veterans returning from Iraq and Afghanistan. A study by Marek Brezezinski, from San Francisco VA Medical Center (California, USA), and colleagues has found that veterans with PTSD face an increased risk for dying after surgery, even if the surgery is performed years after they have completed their service.  The researchers analyzed data on 1,792 male veterans who had major non-cardiac, non-emergency surgeries between 1998 and 2008. Of that group, 129 (7.8%) had been diagnosed with posttraumatic stress disorder (PTSD) before their surgery.  Notable is that the men with PTSD were an average of seven years younger than those without PTSD -- 59 versus 66 years old -- but were much more likely to have cardiac risk factors. .The team determined that one year after surgery, the death rate among men with PTSD was 25% higher than for those without PTSD -- 8.5% versus 6.8%. After the researchers adjusted for confounding factors, they found that veterans with PTSD were 2.2 times more likely to die within a year of surgery than those without PTSD. The team concludes that: ““The magnitude of the detrimental effect of PTSD diagnosis on postoperative mortality is unexpectedly large -- greater than that of diabetes, which is an established risk factor for patients undergoing surgery.”