Walilko Timothy, North Carol, Young Lee Ann, Lux Warren E, Warden Deborah L, Jaffee Michael S, Moore David F
Applied Research Associates, San Antonio, Texas, USA.
J Trauma. 2009 Dec;67(6):1311-9. doi: 10.1097/TA.0b013e31819adc36.
The aim of the Oklahoma City (OKC) bombing retrospective review was to investigate the relationship between physical injury, environmental contributors, and psychiatric disorders such as posttraumatic stress disorder (PTSD) in an event-based, matched design study focused on injury.
The 182 selected participants were a random subset of the 1,092 direct survivors from the OKC bombing. Only 124 of these 182 cases had a full complement of medical/clinical data in the OKC database. These 124 cases were assessed to explore relationships among PTSD diagnoses, levels of blast exposure, and physical injuries. Associations among variables were statistically tested using contingency analysis and logistic regression.
Comparison of the PTSD cases to symptoms/diagnoses reported in the medical records reveals a statistically significant association between PTSD and head/brain injuries associated with head acceleration. PTSD was not highly correlated with other injuries. Although blast pressure and impulse were highly correlated with head injuries, the correlation with PTSD was not statistically significant. Thus, a correlation between blast pressure and PTSD may exist, but higher fidelity pressure calculations are required to elucidate this potential relationship.
This study provides clear evidence that head injury is associated with subsequent PTSD, giving caregivers' information on what physical injuries may suggest the development of psychologic disorders to aid them in developing a profile for the identification of future survivors of terrorist attacks and Warfighters with brain injuries and potential PTSD.
俄克拉荷马城（OKC）爆炸事件回顾性研究的目的是，在一项基于事件的、匹配设计的聚焦于损伤的研究中，调查身体损伤、环境因素与创伤后应激障碍（PTSD）等精神障碍之间的关系。
182名选定参与者是俄克拉荷马城爆炸事件1092名直接幸存者的随机子集。在这182例中，只有124例在俄克拉荷马城数据库中有完整的医疗/临床数据。对这124例进行评估，以探讨PTSD诊断、爆炸暴露水平和身体损伤之间的关系。使用列联分析和逻辑回归对变量之间的关联进行统计学检验。
将PTSD病例与医疗记录中报告的症状/诊断进行比较，结果显示PTSD与与头部加速相关的头部/脑部损伤之间存在统计学上的显著关联。PTSD与其他损伤的相关性不高。虽然爆炸压力和冲量与头部损伤高度相关，但与PTSD的相关性在统计学上并不显著。因此，爆炸压力与PTSD之间可能存在关联，但需要更高保真度的压力计算来阐明这种潜在关系。
本研究提供了明确证据，表明头部损伤与随后的PTSD相关，为护理人员提供了关于哪些身体损伤可能提示心理障碍发展的信息，以帮助他们建立一个档案，用于识别未来恐怖袭击的幸存者以及患有脑损伤和潜在PTSD的战士。
