Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States
Purpose Posttraumatic stress disorder (PTSD) is prevalent and is associated with protracted recovery and worse outcomes after injury. This study compared PTSD prevalence using the PTSD checklist for DSM-5 (PCL-5) with the prevalence of PTSD risk using the Injured Trauma Survivor Screen (ITSS). Metho...
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Korean Society of Traumatology
2024-03-01
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Series: | Journal of Trauma and Injury |
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Online Access: | http://jtraumainj.org/upload/pdf/jti-2023-0068.pdf |
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author | Victoria J. Nedder Mary A. Breslin Vanessa P. Ho Heather A. Vallier |
author_facet | Victoria J. Nedder Mary A. Breslin Vanessa P. Ho Heather A. Vallier |
author_sort | Victoria J. Nedder |
collection | DOAJ |
description | Purpose Posttraumatic stress disorder (PTSD) is prevalent and is associated with protracted recovery and worse outcomes after injury. This study compared PTSD prevalence using the PTSD checklist for DSM-5 (PCL-5) with the prevalence of PTSD risk using the Injured Trauma Survivor Screen (ITSS). Methods Adult trauma patients at a level I trauma center were screened with the PCL-5 (sample 1) at follow-up visits or using the ITSS as inpatients (sample 2). Results Sample 1 (n=285) had significantly fewer patients with gunshot wounds than sample 2 (n=45) (8.1% vs. 22.2%, P=0.003), nonsignificantly fewer patients with a fall from a height (17.2% vs. 28.9%, P=0.06), and similar numbers of patients with motor vehicle collision (40.7% vs. 37.8%, P=0.07). Screening was performed at a mean of 154 days following injury for sample 1 versus 7.1 days in sample 2. The mean age of the patients in sample 1 was 45.4 years, and the mean age of those in sample 2 was 46.1 years. The two samples had similar proportions of female patients (38.2% vs. 40.0%, P=0.80). The positive screening rate was 18.9% in sample 1 and 40.0% in sample 2 (P=0.001). For specific mechanisms, the positive rates were as follows: motor vehicle collisions, 17.2% in sample 1 and 17.6% in sample 2 (P>0.999); fall from height, 12.2% in sample 1 and 30.8% in sample 2 (P=0.20); and gunshot wounds, 39.1% in sample 1 and 80.0% in sample 2 (P=0.06). Conclusions The ITSS was obtained earlier than PCL-5 and may identify PTSD in more orthopedic trauma patients. Differences in the frequency of PTSD may also be related to the screening tool itself, or underlying patient risk factors, such as mechanism of injury, or mental or social health. |
format | Article |
id | doaj-art-75ce788e7ceb4e6d9145af9b19636d19 |
institution | Kabale University |
issn | 2799-4317 2287-1683 |
language | English |
publishDate | 2024-03-01 |
publisher | Korean Society of Traumatology |
record_format | Article |
series | Journal of Trauma and Injury |
spelling | doaj-art-75ce788e7ceb4e6d9145af9b19636d192025-01-16T06:10:09ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832024-03-01371677310.20408/jti.2023.00681298Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United StatesVictoria J. Nedder0Mary A. Breslin1Vanessa P. Ho2Heather A. Vallier3 Case Western Reserve University, Cleveland, OH, USA Case Western Reserve University, Cleveland, OH, USA Case Western Reserve University, Cleveland, OH, USA Case Western Reserve University, Cleveland, OH, USAPurpose Posttraumatic stress disorder (PTSD) is prevalent and is associated with protracted recovery and worse outcomes after injury. This study compared PTSD prevalence using the PTSD checklist for DSM-5 (PCL-5) with the prevalence of PTSD risk using the Injured Trauma Survivor Screen (ITSS). Methods Adult trauma patients at a level I trauma center were screened with the PCL-5 (sample 1) at follow-up visits or using the ITSS as inpatients (sample 2). Results Sample 1 (n=285) had significantly fewer patients with gunshot wounds than sample 2 (n=45) (8.1% vs. 22.2%, P=0.003), nonsignificantly fewer patients with a fall from a height (17.2% vs. 28.9%, P=0.06), and similar numbers of patients with motor vehicle collision (40.7% vs. 37.8%, P=0.07). Screening was performed at a mean of 154 days following injury for sample 1 versus 7.1 days in sample 2. The mean age of the patients in sample 1 was 45.4 years, and the mean age of those in sample 2 was 46.1 years. The two samples had similar proportions of female patients (38.2% vs. 40.0%, P=0.80). The positive screening rate was 18.9% in sample 1 and 40.0% in sample 2 (P=0.001). For specific mechanisms, the positive rates were as follows: motor vehicle collisions, 17.2% in sample 1 and 17.6% in sample 2 (P>0.999); fall from height, 12.2% in sample 1 and 30.8% in sample 2 (P=0.20); and gunshot wounds, 39.1% in sample 1 and 80.0% in sample 2 (P=0.06). Conclusions The ITSS was obtained earlier than PCL-5 and may identify PTSD in more orthopedic trauma patients. Differences in the frequency of PTSD may also be related to the screening tool itself, or underlying patient risk factors, such as mechanism of injury, or mental or social health.http://jtraumainj.org/upload/pdf/jti-2023-0068.pdfinjurytraumaposttraumatic stress disordermental illness |
spellingShingle | Victoria J. Nedder Mary A. Breslin Vanessa P. Ho Heather A. Vallier Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States Journal of Trauma and Injury injury trauma posttraumatic stress disorder mental illness |
title | Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States |
title_full | Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States |
title_fullStr | Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States |
title_full_unstemmed | Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States |
title_short | Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States |
title_sort | prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the injured trauma survivor screen as a prospective screening protocol in the united states |
topic | injury trauma posttraumatic stress disorder mental illness |
url | http://jtraumainj.org/upload/pdf/jti-2023-0068.pdf |
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