McMinn Kenleigh R, Bennett Monica, Powers Mark B, Foreman Michael L, Reddy Likith V, Warren Ann Marie
Postdoctoral Fellow, Psychology Specialists, Bloomington, IL.
Biostatistician, Department of Surgery, Baylor Scott & White Health, Dallas, TX.
J Oral Maxillofac Surg. 2018 Dec;76(12):2610.e1-2610.e8. doi: 10.1016/j.joms.2018.08.006. Epub 2018 Aug 20.
The face and head play critical roles in one's sense of self and body image; as such, facial, head, and scalp injuries and potential associated disfigurement can lead to particular difficulties in coping. This study examined the psychosocial outcomes of patients with craniofacial (CF) trauma 1 year after injury and compared these outcomes with those of other traumatically injured patients who did not sustain such injuries. It was hypothesized that participants in the CF injury group would have worse outcomes than those without CF trauma.
This prospective longitudinal study included patients at least 18 years of age admitted to the trauma service of a level I trauma center for at least 24 hours. Demographic and injury-related variables were collected. CF injury was determined by International Classification of Diseases, Ninth Revision codes. Outcomes were measured at baseline and at 12 months and included depression, post-traumatic stress disorder (PTSD), alcohol use, and pain severity. Paired t tests and logistic regression were used for analysis.
Fifteen percent (n = 35) of the study sample (N = 230) had CF injuries. Those with CF injuries had lower income, higher injury severity, and higher intensive care unit admission rates. The CF and non-CF trauma groups did not differ in rates of depression or PTSD at either time point. However, participants with CF trauma had higher odds of risky alcohol use than those without CF trauma at baseline and lower odds of a higher pain severity score at baseline and 12 months.
The groups did not differ in depression and PTSD. However, rates of depression, PTSD, alcohol use, and physical pain were higher than expected for the 2 groups. Given the high rate of psychological morbidity found after CF trauma, patients with these injuries should be screened for symptoms soon after injury and provided with resources for treatment.
面部和头部在个人的自我认知和身体形象中起着关键作用；因此，面部、头部和头皮损伤以及潜在的相关毁容可能导致应对方面的特殊困难。本研究调查了颅面（CF）创伤患者受伤1年后的心理社会结局，并将这些结局与其他未遭受此类损伤的创伤患者的结局进行比较。研究假设CF损伤组的参与者的结局会比无CF创伤的参与者更差。
这项前瞻性纵向研究纳入了至少18岁、在一级创伤中心创伤科住院至少24小时的患者。收集了人口统计学和与损伤相关的变量。CF损伤通过国际疾病分类第九版编码确定。在基线和12个月时测量结局，包括抑郁、创伤后应激障碍（PTSD）、酒精使用和疼痛严重程度。采用配对t检验和逻辑回归进行分析。
研究样本（N = 230）中有15%（n = 35）患有CF损伤。患有CF损伤的患者收入较低、损伤严重程度较高且重症监护病房入住率较高。CF创伤组和非CF创伤组在两个时间点的抑郁或PTSD发生率均无差异。然而，CF创伤参与者在基线时危险饮酒的几率高于无CF创伤者，在基线和12个月时疼痛严重程度评分较高的几率较低。
两组在抑郁和PTSD方面无差异。然而，两组的抑郁、PTSD、酒精使用和身体疼痛发生率均高于预期。鉴于CF创伤后发现的心理疾病发病率较高，这些受伤患者应在受伤后不久接受症状筛查，并获得治疗资源。
