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

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Herrera-Escobar, JP; Al Rafai, SS; Seshadri, AJ; Weed, C; Apoj, M; Harlow, A; Brasel, K; Kasotakis, G; Kaafarani, HMA; Velmahos, G; Salim, A; Haider, AH; Nehra, D

Published Date

  • December 2018

Published In

Volume / Issue

  • 164 / 6

Start / End Page

  • 1246 - 1250

PubMed ID

  • 30170820

Pubmed Central ID

  • 30170820

Electronic International Standard Serial Number (EISSN)

  • 1532-7361

Digital Object Identifier (DOI)

  • 10.1016/j.surg.2018.07.017

Language

  • eng

Conference Location

  • United States