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

Juan P. Herrera-Escobar, Syeda S. Al Rafai, Anupamaa J. Seshadri, Christina Weed, Michel Apoj, Alyssa Harlow, Karen Brasel, George Kasotakis, Haytham M.A. Kaafarani, George Velmahos, Ali Salim, Adil H. Haider, Deepika Nehra

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalSurgery (United States)
DOIs
StateAccepted/In press - Jan 1 2018

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Post-Traumatic Stress Disorders
Multicenter Studies
Wounds and Injuries
Logistic Models
Injury Severity Score
Trauma Centers
Mental Disorders
Mental Health

ASJC Scopus subject areas

  • Surgery

Cite this

Herrera-Escobar, J. P., Al Rafai, S. S., Seshadri, A. J., Weed, C., Apoj, M., Harlow, A., ... Nehra, D. (Accepted/In press). A multicenter study of post-traumatic stress disorder after injury: Mechanism matters more than injury severity. Surgery (United States). https://doi.org/10.1016/j.surg.2018.07.017

A multicenter study of post-traumatic stress disorder after injury : Mechanism matters more than injury severity. / Herrera-Escobar, Juan P.; Al Rafai, Syeda S.; Seshadri, Anupamaa J.; Weed, Christina; Apoj, Michel; Harlow, Alyssa; Brasel, Karen; Kasotakis, George; Kaafarani, Haytham M.A.; Velmahos, George; Salim, Ali; Haider, Adil H.; Nehra, Deepika.

In: Surgery (United States), 01.01.2018.

Research output: Contribution to journalArticle

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 2018, 'A multicenter study of post-traumatic stress disorder after injury: Mechanism matters more than injury severity', Surgery (United States). https://doi.org/10.1016/j.surg.2018.07.017
Herrera-Escobar, Juan P. ; Al Rafai, Syeda S. ; Seshadri, Anupamaa J. ; Weed, Christina ; Apoj, Michel ; Harlow, Alyssa ; Brasel, Karen ; Kasotakis, George ; Kaafarani, Haytham M.A. ; Velmahos, George ; Salim, Ali ; Haider, Adil H. ; Nehra, Deepika. / A multicenter study of post-traumatic stress disorder after injury : Mechanism matters more than injury severity. In: Surgery (United States). 2018.
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abstract = "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.",
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AU - Seshadri, Anupamaa J.

AU - Weed, Christina

AU - Apoj, Michel

AU - Harlow, Alyssa

AU - Brasel, Karen

AU - Kasotakis, George

AU - Kaafarani, Haytham M.A.

AU - Velmahos, George

AU - Salim, Ali

AU - Haider, Adil H.

AU - Nehra, Deepika

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N2 - 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.

AB - 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.

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