A multicenter study of post-traumatic stress disorder after injury: Mechanism matters more than injury severity.

Autor: Herrera-Escobar JP; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard T. H Chan School of Public Health, Boston, MA., Al Rafai SS; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard T. H Chan School of Public Health, Boston, MA., Seshadri AJ; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard T. H Chan School of Public Health, Boston, MA., Weed C; Department of Surgery, Virginia Mason Medical Center, Seattle, WA., Apoj M; Department of Surgery, Division of Trauma, Acute Care Surgery & Surgical Critical Care, Boston University School of Medicine, Boston, MA., Harlow A; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard T. H Chan School of Public Health, Boston, MA., Brasel K; Department of Surgery, Division of Trauma, Critical Care & Acute Care Surgery, Oregon Health and Science University, Portland, OR., Kasotakis G; Department of Surgery, Division of Trauma, Acute Care Surgery & Surgical Critical Care, Boston University School of Medicine, Boston, MA., Kaafarani HMA; Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Velmahos G; Department of Surgery, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA., Salim A; Department of Surgery, Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Haider AH; Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School and Harvard T. H Chan School of Public Health, Boston, MA; Department of Surgery, Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Nehra D; Department of Surgery, Division of Trauma, Burn and Surgical Critical Care, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Electronic address: dnehra@partners.org.
Jazyk: angličtina
Zdroj: Surgery [Surgery] 2018 Dec; Vol. 164 (6), pp. 1246-1250. Date of Electronic Publication: 2018 Aug 29.
DOI: 10.1016/j.surg.2018.07.017
Abstrakt: Background: Traumatic injury is strongly associated with long-term mental health disorders, but the risk factors for developing these disorders are poorly understood. We report on a multi-institutional collaboration to collect long-term patient-centered outcomes after trauma, including screening for post-traumatic stress disorder. The objective of this study is to determine the prevalence of and risk factors for the development of post-traumatic stress disorder after traumatic injury.
Methods: Adult trauma patients (aged 18-64) with moderate to severe injuries (Injury Severity Score ≥ 9) admitted to 3 level I trauma centers were screened between 6 and 12 months after injury for post-traumatic stress disorder. Patients were divided by mechanism: fall, road traffic injury, and intentional injury. Multiple logistic regression models were used to determine the association between baseline patient and injury-related characteristics and the development of post-traumatic stress disorder for the overall cohort and by mechanism of injury.
Results: A total of 450 patients completed the screen. Overall 32% screened positive for post-traumatic stress disorder, but this differed significantly by mechanism, with the lowest being after a fall (25%) and highest after intentional injury (60%). Injury severity was not associated with post-traumatic stress disorder for any group, but lower educational level was associated with post-traumatic stress disorder within all the groups. Only 21% of patients who screened positive for post-traumatic stress disorder were receiving treatment at the time of the survey.
Conclusion: Post-traumatic stress disorder is common after traumatic injury, and the prevalence varies significantly by injury mechanism but is not associated with injury severity. Only a small proportion of patients who screen positive for post-traumatic stress disorder are currently receiving treatment.
(Copyright © 2018 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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