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预测烧伤后抑郁和创伤后应激症状:风险评分系统。

Predicting Depression and Posttraumatic Stress Symptoms Following Burn Injury: A Risk Scoring System.

机构信息

Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, Massachusetts, USA.

Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, USA.

出版信息

J Burn Care Res. 2022 Jul 1;43(4):899-905. doi: 10.1093/jbcr/irab215.

Abstract

Depression and posttraumatic stress (DPTS) are common psychiatric comorbidities following burn injury. The purpose of this study was to develop an admission scoring system that assesses the risk of development of depression or posttraumatic symptoms in the burn population. This study is a retrospective review of the prospectively collected Burn Model System National Database. Adult burn survivors enrolled from 2014 to 2018 (n = 486) were included. The primary outcome was the presence of DPTS symptoms at 6, 12, or 24 months postinjury. Logistic regression analysis was used to identify demographic and clinical predictors of DPTS symptoms. A risk scoring system was then created based on assigning point values to relevant predictor factors. The study population had a mean age of 46.5 ± 15.8 years, mean burn size of 18.3 ± 19.7%, and was 68.3% male. Prior to injury, 71.3% of the population was working, 47.9% were married, and 50.8% had completed more than a high school education. An 8-point risk scoring system was developed using the following predictors of DPTS symptom development: gender, psychiatric treatment in the past year, graft size, head/neck graft, etiology of injury, and education level. This study is the first to develop a DPTS symptom risk scoring system for burn injury. This scoring system will aid in identifying burn survivors at high risk of long-term psychiatric symptoms that may be used to improve screening, monitoring, timely diagnosis, and interventions.

摘要

抑郁和创伤后应激(DPTS)是烧伤后常见的精神共病。本研究旨在开发一种入院评分系统,以评估烧伤人群中抑郁或创伤后症状发展的风险。本研究是对前瞻性收集的烧伤模型系统国家数据库进行的回顾性分析。纳入了 2014 年至 2018 年登记的成年烧伤幸存者(n=486)。主要结局是受伤后 6、12 或 24 个月时 DPTS 症状的存在。使用逻辑回归分析确定 DPTS 症状的人口统计学和临床预测因素。然后根据相关预测因素赋予分值创建风险评分系统。研究人群的平均年龄为 46.5±15.8 岁,平均烧伤面积为 18.3±19.7%,男性占 68.3%。受伤前,71.3%的人在工作,47.9%的人已婚,50.8%的人受过高中以上教育。使用以下 DPTS 症状发展的预测因素开发了一个 8 分风险评分系统:性别、过去一年的精神科治疗、移植物大小、头/颈部移植物、损伤病因和教育水平。这是第一个为烧伤开发 DPTS 症状风险评分系统的研究。该评分系统将有助于识别有长期精神症状高风险的烧伤幸存者,可用于改善筛查、监测、及时诊断和干预。

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