OBJECTIVES: To evaluate the prevalence of PTSD symptoms in individuals who are further removed from injury (up to three years) and to identify injury specific characteristics that are associated with an increased risk for persistent PTSD symptoms.
DESIGN: Cross-sectional, retrospective cohort. SETTING: Level I Trauma CenterPATIENTS/PARTICIPANTS: 243 patients operatively treated for orthopaedic trauma between March 2017 through June 2018. INTERVENTION: Orthopaedic trauma requiring operative intervention. MAIN OUTCOME MEASUREMENTS: The primary outcome was score on the PTSD Checklist for the DSM-5 (PCL-5) survey. A score of 31 or higher was considered concerning for PTSD.
RESULTS: 49 respondents scored positive for PTSD out of 239 (20.5%). Multivariate analysis demonstrated an increased risk of PTSD for patients with a history of smoking and those that required delayed re-operation (greater than 90 days post-operative). Caucasian race and low energy mechanisms of injury were associated with decreased risk of PTSD. Fracture locations were not associated with a higher likelihood of PTSD.
CONCLUSIONS: The prevalence of PTSD symptoms in patients up to three years after surgery remains higher than the estimated prevalence of PTSD in the general United States population. It is similar to previously documented rates of PTSD for patients less than one year after injury. Long-term complication requiring re-operation was associated with an increased risk of persistent PTSD symptoms. Orthopaedic providers should be mindful of PTSD symptoms not only in the immediate post-operative period but throughout the treatment course particularly for those with identified PTSD risk factors. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.