RT Journal Article
SR Electronic
T1 Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool
JF Trauma Surgery & Acute Care Open
JO Trauma Surg Acute Care Open
FD BMJ Publishing Group Ltd
SP e000623
DO 10.1136/tsaco-2020-000623
VO 6
IS 1
A1 Saad Rahmat
A1 Jessica Velez
A1 Muhammad Farooqi
A1 Abbas Smiley
A1 Kartik Prabhakaran
A1 Peter Rhee
A1 Maria Khan
A1 Rhea Dornbush
A1 Stephen Ferrando
A1 Yvette Smolin
YR 2021
UL http://tsaco.bmj.com/content/6/1/e000623.abstract
AB Background Post-traumatic stress disorder (PTSD) has debilitating psychiatric and medical consequences. The purpose of this study was to identify whether PTSD diagnosis and PTSD symptom scale score (PTSD severity) could be predicted by assessing peritraumatic experiences using a single question or screening tools at different time points in patients hospitalized after admission to the hospital after significant physical trauma, but with stable vitals (level II trauma).Methods Patients completed the ‘initial question’ and the National Stressful Events Survey Acute Stress Disorder Scale (NSESSS) at 3 days to 5 days after trauma (NSESSS-1). The same scale was administered 2 weeks to 4 weeks after trauma (NSESSS-2). The Posttraumatic Stress Disorder Symptoms Scale Interview for DSM-5 (PSSI-5) was administered 2 months after trauma. PTSD diagnosis and PTSD severity were extracted from the PSSI-5. Linear multivariate regression analyses were used to establish whether scores for NSESSS-1 or NSESSS-2 predicted PTSD diagnosis/PTSD severity. Non-linear multivariate regression analyses were performed to better understand the relationship between NSESSS-1/NSESSS-2 and PTSD diagnosis/PTSD severity.Results A single question assessing the experience of fear, helplessness, or horror was not an effective tool for determining the diagnosis of PTSD (p=0.114) but can be a predictor of PTSD severity (p=0.039). We demonstrate that administering the NSESSS after either 3 days to 5 days (p=0.008, p<0.001) or 2 weeks to 4 weeks (p=0.039; p<0.001) can predict the diagnosis of PTSD and PTSD severity. Scoring an NSESSS above 14/28 (50%) increases the chance of experiencing a higher PTSD severity substantially and linearly.Discussion Our initial question was not an effective predictor of PTSD diagnosis. However, using the NSESSS at both 3 days to 5 days and 2 weeks to 4 weeks after trauma is an effective method for predicting PTSD diagnosis and PTSD severity. Additionally, we show that patients who score higher than 14 on the NSESSS for acute stress symptoms may need closer follow-up.Level of evidence Level III, prognostic.Data are available upon reasonable request. The deidentified participant data (including demographics, scores on the screening questionnaires, and the original screening questionnaires) are available from Dr Yvette Smolin by contacting Yvette.Smolin@wmchealth.org.