Association between the number of individuals injured in a traumatic event and posttraumatic stress disorder among hospitalized trauma patients.


Journal

Journal of traumatic stress
ISSN: 1573-6598
Titre abrégé: J Trauma Stress
Pays: United States
ID NLM: 8809259

Informations de publication

Date de publication:
25 Oct 2024
Historique:
revised: 14 09 2024
received: 13 07 2024
accepted: 14 09 2024
medline: 25 10 2024
pubmed: 25 10 2024
entrez: 25 10 2024
Statut: aheadofprint

Résumé

Posttraumatic stress disorder (PTSD) often occurs following mass casualty events, yet the connection between the number of individuals injured in an event and PTSD risk in smaller-scale events (i.e., involving one or several injured persons) remains unclear. We conducted a registries-based study cross-referencing three databases across the continuum of care for military trauma patients hospitalized for traumatic injuries. The study population was categorized into three groups based on the number of injured individuals involved (i.e., single injured person, two to four [2-4] injured people, and five or more [≥ 5] injured people), and PTSD prevalence was assessed using long-term disability claim diagnoses. Overall, 4,030 military personnel were included (age at injury: Mdn = 20 years), and 18.3% were subsequently diagnosed with PTSD, with the highest prevalence in events involving ≥ 5 injured individuals (35.8%). Regression analyses adjusted for potential confounders revealed that being injured in an event with 2-4 injured persons, OR = 1.68, 95% CI [1.31, 2.15], or ≥ 5 injured persons, OR = 2.36, 95% CI [1.79, 3.13], was associated with increased odds of developing PTSD compared to being the sole injured person. The findings suggest a direct association between the number of injured individuals in an event and PTSD prevalence among traumatic injury survivors. The results underscore the importance of early diagnosis and interventions to prevent PTSD in individuals injured in multicasualty and mass casualty events.

Identifiants

pubmed: 39449553
doi: 10.1002/jts.23110
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 The Author(s). Journal of Traumatic Stress published by Wiley Periodicals LLC on behalf of International Society for Traumatic Stress Studies.

Références

Agarwal, T. M., Muneer, M., Asim, M., Awad, M., Afzal, Y., Al‐Thani, H., Alhassan, A., Mollazehi, M., & El‐Menyar, A. (2020). Psychological trauma in different mechanisms of traumatic injury: A hospital‐based cross‐sectional study. PLoS One, 15(11), Article 0242849. https://doi.org/10.1371/journal.pone.0242849
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Baker, S. P., O'Neill, B., Haddon, W., & Long, W. B. (1974). The Injury Severity Score: A method for describing patients with multiple injuries and evaluating emergency care. Journal of Trauma, 14(3), 187–196.
Bing‐Canar, H., Ranney, R. M., McNett, S., Tran, J. K., Berenz, E. C., & Vujanovic, A. A. (2019). Alcohol use problems, posttraumatic stress disorder, and suicide risk among trauma‐exposed firefighters. Journal of Nervous and Mental Disease, 207(3), 192–198. https://doi.org/10.1097/nmd.0000000000000947
Bisson, J. I., Wright, L. A., Jones, K. A., Lewis, C., Phelps, A. J., Sijbrandij, M., Varker, T., & Roberts, N. P. (2021). Preventing the onset of post traumatic stress disorder. Clinical Psychology Review, 86, Article 102004. https://doi.org/10.1016/j.cpr.2021.102004
Boals, A., Trost, Z., Rainey, E., Foreman, M. L., & Warren, A. M. (2017). Severity of traumatic injuries predicting psychological outcomes: A surprising lack of empirical evidence. Journal of Anxiety Disorders, 50, 1–6. https://doi.org/10.1016/j.janxdis.2017.04.004
Brackbill, R. M., Cone, J. E., Farfel, M. R., & Stellman, S. D. (2014). Chronic physical health consequences of being injured during the terrorist attacks on World Trade Center on September 11, 2001. American Journal of Epidemiology, 179(9), 1076–1085. https://doi.org/10.1093/aje/kwu022
Bulis, S., Talmy, T., Radomislensky, I., Gelman, D., Bushinsky, S., Nachum, D., Tomer, G., Tsur, A. M., Paulman, O., Gendler, S., Almog, O., & Benov, A. (2023). The association between Glasgow Coma Scale scores and PTSD in military trauma casualties: Does mental status following injury play a role in PTSD development? Military Medicine, 188(Suppl 6), 428–435. https://doi.org/10.1093/milmed/usad180
Conrad, D., Wilker, S., Pfeiffer, A., Lingenfelder, B., Ebalu, T., Lanzinger, H., Elbert, T., Kolassa, I. T., & Kolassa, S. (2017). Does trauma event type matter in the assessment of traumatic load? European Journal of Psychotraumatology, 8(1), Article 1344079. https://doi.org/10.1080/20008198.2017.1344079
deRoon‐Cassini, T. A., Hunt, J. C., Geier, T. J., Warren, A. M., Ruggiero, K. J., Scott, K., George, J., Halling, M., Jurkovich, G., Fakhry, S. M., Zatzick, D., & Brasel, K. J. (2019). Screening and treating hospitalized trauma survivors for PTSD and depression. Journal of Trauma and Acute Care Surgery, 87(2), 440–450. https://doi.org/10.1097/TA.0000000000002370
Ferry, F., Bunting, B., Murphy, S., O'Neill, S., Stein, D., & Koenen, K. (2014). Traumatic events and their relative PTSD burden in Northern Ireland: A consideration of the impact of the “Troubles.” Social Psychiatry and Psychiatric Epidemiology, 49(3), 435–446. https://doi.org/10.1007/S00127‐013‐0757‐0
Foa, E. B., Hembree, E. A., Rothbaum, B. O., & Rauch, S. A. M. (2019). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences: Therapist guide (2nd ed). Oxford University Press.
Freed, M. C., Goldberg, R. K., Gore, K. L., & Engel, C. C. (2010). Estimating the disease burden of combat‐related posttraumatic stress disorder in United States veterans and military service members. In V. R. Preedy & R. R. Watson (Eds.), Handbook of disease burdens and quality of life measures (pp. 1527–1548). Springer. https://doi.org/10.1007/978‐0‐387‐78665‐0_89
French, P., Barrett, A., Allsopp, K., Williams, R., Brewin, C. R., Hind, D., Sutton, R., Stancombe, J., & Chitsabesan, P. (2019). Psychological screening of adults and young people following the Manchester Arena incident. BJPsych Open, 5(5), Article e85. https://doi.org/10.1192/BJO.2019.61
Galea, S., Nandi, A., & Vlahov, D. (2005). The epidemiology of post‐traumatic stress disorder after disasters. Epidemiologic Reviews, 27(1), 78–91. https://doi.org/10.1093/epirev/mxi003
García‐Vera, M. P., Sanz, J., & Gutiérrez, S. (2016). A systematic review of the literature on posttraumatic stress disorder in victims of terrorist attacks. Psychological Reports, 119(1), 328–359. https://doi.org/10.1177/0033294116658243
Giummarra, M. J., Lennox, A., Dali, G., Costa, B., & Gabbe, B. J. (2018). Early psychological interventions for posttraumatic stress, depression and anxiety after traumatic injury: A systematic review and meta‐analysis. Clinical Psychology Review, 62, 11–36. https://doi.org/10.1016/J.CPR.2018.05.001
Hendin, H., & Haas, A. P. (1991). Suicide and guilt as manifestations of PTSD in Vietnam combat veterans. American Journal of Psychiatry, 148(5), 586–591. https://doi.org/10.1176/AJP.148.5.586
Hirschberg, A., & Stein, M. (2008). Trauma care in mass casualty incidents. In D. V. Feliciano, K. L. Mattox, & E. E. Moore, Trauma (6th ed.; pp. 141–155). McGraw‐Hill.
Hoppen, T. H., Priebe, S., Vetter, I., & Morina, N. (2021). Global burden of post‐traumatic stress disorder and major depression in countries affected by war between 1989 and 2019: A systematic review and meta‐analysis. BMJ Global Health, 6(7), Article 6303. https://doi.org/10.1136/BMJGH‐2021‐006303
Hourani, L., Williams, J., Bray, R., & Kandel, D. (2015). Gender differences in the expression of PTSD symptoms among active duty military personnel. Journal of Anxiety Disorders, 29, 101–108. https://doi.org/10.1016/j.janxdis.2014.11.007
Jakob, J. M. D., Lamp, K., Rauch, S. A. M., Smith, E. R., & Buchholz, K. R. (2017). The impact of trauma type or number of traumatic events on PTSD diagnosis and symptom severity in treatment‐seeking veterans. Journal of Nervous and Mental Disease, 205(2), 83–86. https://doi.org/10.1097/NMD.0000000000000581
Kearns, M. C., Ressler, K. J., Zatzick, D., & Rothbaum, B. O. (2012). Early interventions for PTSD: A review. Depression and Anxiety, 29(10), 833–842. https://doi.org/10.1002/DA.21997
Kelley, L. P., Weathers, F. W., McDevitt‐Murphy, M. E., Eakin, D. E., & Flood, A. M. (2009). A comparison of PTSD symptom patterns in three types of civilian trauma. Journal of Traumatic Stress, 22(3), 227–235. https://doi.org/10.1002/jts.20406
Kilpatrick, D. G., Resnick, H. S., Milanak, M. E., Miller, M. W., Keyes, K. M., & Friedman, M. J. (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM‐IV and DSM‐5 criteria. Journal of Traumatic Stress, 26(5), 537–547. https://doi.org/10.1002/JTS.21848
Kintzle, S., Barr, N., Corletto, G., & Castro, C. A. (2018). PTSD in U.S. veterans: The Role of social connectedness, combat experience and discharge. Healthcare, 6(3), 102. https://doi.org/10.3390/healthcare6030102
Koren, D., Norman, D., Cohen, A., Berman, J., & Klein, E. M. (2005). Increased PTSD risk with combat‐related injury: a matched comparison study of injured and uninjured soldiers experiencing the same combat events. American Journal of Psychiatry, 162(2), 276–282. https://doi.org/10.1176/appi.ajp.162.2.276
Larsen, S. E., Hunt, J. C., Geier, T., Heyrman, K., Schumann, N., Brandolino, A., Timmer‐Murillo, S., Bergner, C., Larson, C., & deRoon‐Cassini, T. A. (2021). A randomized trial of modified prolonged exposure to prevent the development of posttraumatic stress disorder in patients hospitalized with traumatic injuries. Journal of Traumatic Stress, 34(1), 104–115. https://doi.org/10.1002/jts.22580
Lehavot, K., Katon, J. G., Chen, J. A., Fortney, J. C., & Simpson, T. L. (2018). Post‐traumatic stress disorder by gender and veteran status. American Journal of Preventive Medicine, 54(1), e1–e9. https://doi.org/10.1016/j.amepre.2017.09.008
Lowe, S. R., & Galea, S. (2017). The mental health consequences of mass shootings. Trauma, Violence & Abuse, 18(1), 62–82. https://doi.org/10.1177/1524838015591572
Manser, S. S., Houck, K., Kramer, M. D., Tabas, I. A., Brown, C. V. R., & Coopwood, B. (2018). Do screening and a randomized brief intervention at a Level 1 trauma center impact acute stress reactions to prevent later development of posttraumatic stress disorder? Journal of Trauma and Acute Care Surgery, 85(3), 466–475. https://doi.org/10.1097/ta.0000000000001977
Martindale, S. L., Ord, A. S., Rule, L. G., & Rowland, J. A. (2021). Effects of blast exposure on psychiatric and health symptoms in combat veterans. Journal of Psychiatric Research, 143, 189–195. https://doi.org/10.1016/j.jpsychires.2021.09.021
Mitchnik, I. Y., Talmy, T., Radomislensky, I., Chechik, Y., Shlaifer, A., Almog, O., & Gendler, S. (2022). Femur fractures and hemorrhagic shock: Implications for point of injury treatment. Injury, 53(10), 3416–3422. https://doi.org/10.1016/j.injury.2022.08.053
Monsour, M., Ebedes, D., & Borlongan, C. V. (2022). A review of the pathology and treatment of TBI and PTSD. Experimental Neurology, 351, Article 114009. https://doi.org/10.1016/j.expneurol.2022.114009
Morgan, P. M. (2016). The psychological impact of mass casualty incidents on first responders: A systematic review. Journal of Emergency Management, 14(3), 213–226. https://doi.org/10.5055/jem.2016.0287
Murray, H. L. (2018). Survivor guilt in a posttraumatic stress disorder clinic sample. Journal of Loss and Trauma, 23(7), 600–607. https://doi.org/10.1080/15325024.2018.1507965
Neria, Y., DiGrande, L., & Adams, B. G. (2011). Posttraumatic stress disorder following the September 11, 2001, terrorist attacks: A Review of the literature among highly exposed populations. American Psychologist, 66(6), 429–446. https://doi.org/10.1037/a0024791
Paredes Molina, C. S., Berry, S., Nielsen, A., & Winfield, R. (2018). PTSD in civilian populations after hospitalization following traumatic injury: A comprehensive review. American Journal of Surgery, 216(4), 745–753. https://doi.org/10.1016/j.amjsurg.2018.07.035
Pietrzak, R. H., Whealin, J. M., Stotzer, R. L., Goldstein, M. B., & Southwick, S. M. (2011). An examination of the relation between combat experiences and combat‐related posttraumatic stress disorder in a sample of Connecticut OEF‐OIF veterans. Journal of Psychiatric Research, 45(12), 1579–1584. https://doi.org/10.1016/j.jpsychires.2011.07.010
Prins, A., Bovin, M. J., Kimerling, R., Kaloupek, D. G., Marx, B. P., Pless Kaiser, A., & Schnurr, P. P. (2015). The Primary Care PTSD Screen for DSM‐5 (PC‐PTSD‐5) [Measurement instrument]. https://www.ptsd.va.gov/professional/assessment/documents/pc‐ptsd5‐screen.pdf
Reese, C., Pederson, T., Avila, S., Joseph, K., Nagy, K., Dennis, A., Wiley, D., Starr, F., & Bokhari, F. (2012). Screening for traumatic stress among survivors of urban trauma. Journal of Trauma and Acute Care Surgery, 73(2), 462–468. https://doi.org/10.1097/ta.0b013e31825ff713
Resnick, H. S., Kilpatrick, D. G., Dansky, B. S., Saunders, B. E., & Best, C. L. (1993). Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of Consulting and Clinical Psychology, 61(6), 984–991. https://doi.org/10.1037//0022‐006X.61.6.984
Smith, T. C., Wingard, D. L., Ryan, M. A. K., Kritz‐Silverstein, D., Slymen, D. J., & Sallis, J. F. (2009). PTSD prevalence, associated exposures, and functional health outcomes in a large, population‐based military cohort. Public Health Reports, 124(1), 90–102. https://doi.org/10.1177/003335490912400112
Stefanovics, E. A., Potenza, M. N., & Pietrzak, R. H. (2020). PTSD and obesity in U.S. military veterans: Prevalence, health burden, and suicidality. Psychiatry Research, 291, Article 113242. https://doi.org/10.1016/j.psychres.2020.113242
Tsur, A. M., Nadler, R., Lipsky, A. M., Levi, D., Bader, T., Benov, A., Glassberg, E., & Chen, J. (2020). The Israel Defense Forces Trauma Registry: 22 years of point‐of‐injury data. Journal of Trauma and Acute Care Surgery, 89(2S Suppl 2), S32–S38. https://doi.org/10.1097/ta.0000000000002776
Vázquez, C., Pérez‐Sales, P., & Matt, G. (2006). Post‐traumatic stress reactions following the March 11, 2004, terrorist attacks in a Madrid community sample: A cautionary note about the measurement of psychological trauma. Spanish Journal of Psychology, 9(1), 61–74. https://doi.org/10.1017/S1138741600005989
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2014). The strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies. International Journal of Surgery, 12(12), 1495–1499. https://doi.org/10.1016/j.ijsu.2014.07.013
Xue, C., Ge, Y., Tang, B., Liu, Y., Kang, P., Wang, M., & Zhang, L. (2015). A meta‐analysis of risk factors for combat‐related PTSD among military personnel and veterans. PloS One, 10(3), Article e0120270. https://doi.org/10.1371/journal.pone.0120270
Zatzick, D., Jurkovich, G., Rivara, F. P., Russo, J., Wagner, A., Wang, J., Dunn, C., Lord, S. P., Petrie, M., O'Connor, S. S., & Katon, W. (2013). A randomized stepped care intervention trial targeting posttraumatic stress disorder for surgically hospitalized injury survivors. Annals of Surgery, 257(3), 390–399. https://doi.org/10.1097/sla.0b013e31826bc313
Zhang, G., North, C. S., Narayanan, P., Kim, Y. S., Thielman, S., & Pfefferbaum, B. (2013). The course of postdisaster psychiatric disorders in directly exposed civilians after the US Embassy bombing in Nairobi, Kenya: A follow‐up study. Social Psychiatry and Psychiatric Epidemiology, 48(2), 195–203. https://doi.org/10.1007/s00127‐012‐0535‐4

Auteurs

Tomer Talmy (T)

Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.
Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Division of Anesthesia, Intensive Care, and Pain, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel.

Shir Bulis (S)

Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.

Irina Radomislensky (I)

The National Center for Trauma and Emergency Medicine Research, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-HaShomer, Israel.

Shir Bushinsky (S)

Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel.

Nir Tsur (N)

Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Tel Aviv University, Petach Tiqva, Israel.

Daniel Gelman (D)

Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.

Omer Paulman (O)

Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.

Sami Gendler (S)

Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.

Avishai M Tsur (AM)

Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.
Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Department of Medicine, Sheba Medical Center, Tel-Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ofer Almog (O)

Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.
Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel.

Avi Benov (A)

Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.

Classifications MeSH