Shussman Noam, Mintz Ayelet, Zamir Gideon, Shalev Arye, Gazala Mahmoud Abu, Rivkind Avraham I, Isenberg Yonatan, Bala Miklosh, Almogy Gidon
Department of Surgery and Trauma Unit, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
J Trauma. 2011 Jun;70(6):1546-50. doi: 10.1097/TA.0b013e318202edcf.
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that results from exposure to a traumatic event and consists of intrusive and unwanted recollections; avoidance followed by emotional withdrawal; and heightened physiologic arousal. Hospitalized victims of suicide bombing attacks (SBAs) are unique because of the circumstances and severity of their injuries, which could affect the occurrence and delay the recognition of PTSD. Our objectives were to evaluate the prevalence and severity of PTSD among hospitalized SBA victims and to assess variables of physical injury as risk factors for the development of PTSD.
Forty-six hospitalized SBA victims were evaluated for PTSD using the PTSD symptom scale self-report questionnaire by phone. Demographic and medical data regarding the severity and type of injury and medical treatment were collected from medical files. Injury Severity Score was used to assess severity of physical injury.
Twenty-four of 46 (52.2%) hospitalized SBA victims developed PTSD. Presence of blast lung injury was significantly higher in the PTSD group compared with the non-PTSD group (37.5% versus 9.1%, respectively; p < 0.04). There was no significant difference in Injury Severity Score between PTSD and non-PTSD groups. Blast lung injury and intracranial injury were found to be positive predictors of PTSD (odds ratio, 125 and 25, respectively). No correlation was found between the length of stay, length of intensive care unit stay, or severity of physical injuries and the severity of PTSD.
Hospitalized victims of SBA are considerably vulnerable to develop PTSD. Victims should be monitored closely and treated in conjunction with their physical treatment. Blast lung injury and intracranial injury are predictors of PTSD.
创伤后应激障碍(PTSD)是一种因暴露于创伤性事件而导致的精神障碍,其症状包括侵入性且不受欢迎的回忆、回避行为及随后的情感退缩,以及生理觉醒增强。自杀式爆炸袭击(SBA)的住院受害者因其受伤情况和严重程度而具有特殊性,这可能影响创伤后应激障碍的发生并延迟其识别。我们的目的是评估住院SBA受害者中创伤后应激障碍的患病率和严重程度,并评估身体损伤变量作为创伤后应激障碍发生的危险因素。
通过电话使用创伤后应激障碍症状量表自评问卷对46名住院的SBA受害者进行创伤后应激障碍评估。从医疗档案中收集有关损伤严重程度、类型和治疗的人口统计学和医学数据。损伤严重程度评分用于评估身体损伤的严重程度。
46名住院的SBA受害者中有24名(52.2%)患上创伤后应激障碍。与非创伤后应激障碍组相比,创伤后应激障碍组中爆震性肺损伤的发生率显著更高(分别为37.5%和9.1%;p < 0.04)。创伤后应激障碍组和非创伤后应激障碍组之间的损伤严重程度评分无显著差异。爆震性肺损伤和颅内损伤被发现是创伤后应激障碍的阳性预测因素(优势比分别为125和25)。住院时间、重症监护病房住院时间或身体损伤严重程度与创伤后应激障碍严重程度之间未发现相关性。
住院的SBA受害者极易患上创伤后应激障碍。应对受害者进行密切监测,并在其接受身体治疗的同时进行相应治疗。爆震性肺损伤和颅内损伤是创伤后应激障碍的预测因素。