Post-Traumatic Stress Disorder among Older Adults Experiencing Motor Vehicle Collision: A Multicenter Prospective Cohort Study.

Autor:	Platts-Mills TF; Department of Anesthesiology, University of North Carolina, Chapel Hill, NC; Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC. Electronic address: tplattsm@med.unc.edu., Nebolisa BC; School of Medicine, University of North Carolina, Chapel Hill, NC., Flannigan SA; Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC., Richmond NL; School of Medicine, University of North Carolina, Chapel Hill, NC., Domeier RM; Department of Emergency Medicine, St. Joseph Mercy Health System, Ann Arbor, MI., Swor RA; Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, MI., Hendry PL; Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, FL., Peak DA; Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA., Rathlev NK; Department of Emergency Medicine, Baystate Medical Center, Springfield, MA., Jones JS; Department of Emergency Medicine, Spectrum Health-Butterworth Campus, Grand Rapids, MI., Lee DC; Department of Emergency Medicine, North Shore University Hospital, Manhasset, NY., Jones CW; Department of Emergency Medicine, Cooper University Hospital, Camden, NJ., McLean SA; Department of Anesthesiology, University of North Carolina, Chapel Hill, NC; Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC.
Jazyk:	angličtina
Zdroj:	The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [Am J Geriatr Psychiatry] 2017 Sep; Vol. 25 (9), pp. 953-963. Date of Electronic Publication: 2017 Apr 04.
DOI:	10.1016/j.jagp.2017.03.011
Abstrakt:	Objective: To characterize risk factors for and consequences of post-traumatic stress disorder (PTSD) among older adults evaluated in the emergency department (ED) following motor vehicle collision (MVC). Design: Prospective multicenter longitudinal study (2011-2015). Setting: 9 EDs across the United States. Participants: Adults aged 65 years and older who presented to an ED after MVC without severe injuries. Measurements: PTSD symptoms were assessed 6 months after the ED visit using the Impact of Event Scale-Revised. Results: Of 223 patients, clinically significant PTSD symptoms at 6 months were observed in 21% (95% CI 16%-26%). PTSD symptoms were more common in patients who did not have a college degree, had depressive symptoms prior to the MVC, perceived the MVC as life-threatening, had severe ED pain, and expected their physical or emotional recovery time to be greater than 30 days. Three factors (ED pain severity [0-10 scale], perceived life-threatening MVC [0-10 scale], and pre-MVC depressive symptoms [yes to either of two questions]), predicted 6-month PTSD symptoms with an area under the curve of 0.76. Compared to patients without PTSD symptoms, those with PTSD symptoms were at higher risk for persistent pain (72% versus 30%), functional decline (67% versus 42%), and new disability (49% versus 18%). Conclusions: Among older adults treated in the ED following MVC, clinically significant PTSD symptoms at 6 months were present in 21% of patients and were associated with adverse health outcomes. Increased risk for PTSD development can be identified with moderate accuracy using information readily available in the ED. (Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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