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Journal Article

Citation

Warren AM, Jones AL, Bennett M, Solis JK, Viere G, Reynolds M, Foreman ML. J. Orthop. Trauma 2016; 30(9): e305-11.

Affiliation

Baylor University Medical Center Baylor Scott and White Baylor Research Institute.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/BOT.0000000000000623

PMID

27253481

Abstract

OBJECTIVES: The study purposes were to prospectively evaluate occurrence of posttraumatic stress (PTS) symptoms at hospital admission and six months later in patients with orthopedic injury; to explore differences in PTS symptoms in those with and without orthopedic injury; and to determine if PTS symptoms are influenced by orthopedic injury type.

DESIGN: Prospective, longitudinal observational study SETTING:: Level 1 Trauma CenterPatients/Participants: 259 participants admitted for at least 24 hours. MAIN OUTCOME MEASUREMENTS: The Primary Care PTSD Screen (PC-PTSD) measured PTSD symptoms during hospitalization. The PTSD Checklist-Civilian Version (PC-PTSD) measured PTS symptoms at six months.

RESULTS: In orthopedic patients, 28% had PTS at six months, compared to 34% of non orthopedic patients. Odds ratios were calculated to determine the influence of pain, physical and mental function, depression and work status. At six months, if the pain score was 5 or higher, the odds of PTS symptoms increased to 8.38 (3.55, 19.8), p <0.0001). Those scoring below average in physical function were significantly more likely to have PTS symptoms (OR=7.60 (2.99, 19.32), p<0.0001). The same held true for mental functioning and PTS (OR=11.4 (4.16, 30.9), p<0.0001). Participants who screened positive for depression had a 38.9 (14.5, 104) greater odds (p<0.0001). Participants who did not return to work after injury at six months were significantly more likely to have PTS (OR=16.5 (1.87, 146), p = 0.012). .

CONCLUSIONS: PTSD is common in patients following injury, including those with orthopedic trauma. At six months, pain of 5 or greater, poor physical and mental function, depression, and/or not returning to work appear to be predictive of PTSD. Orthopedic surgeons should identify and refer for PTSD treatment given the high incidence post-injury. LEVEL OF EVIDENCE: Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.


Language: en

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