Department of Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center, 2020 Gravier Street, Floor 3, New Orleans LA 70112, United States.
Department of Behavioral and Community Health Sciences, Louisiana State University Health Sciences Center, 2020 Gravier Street, Floor 3, New Orleans LA 70112, United States.
Injury. 2022 Jul;53(7):2493-2500. doi: 10.1016/j.injury.2022.05.026. Epub 2022 May 27.
Physically-traumatic injuries result in PTSD for approximately 10% of Americans, and this rate is higher among individuals of color and those living in poverty. Individuals of color living in poverty experience lower access to PTSD and other mental health services. Untreated PTSD is associated with increased risk of trauma recidivism, but it is unknown if provision of treatment is actually associated with a subsequent reduction in recidivism risk.
For this observational cross-sectional study, data were collected retrospectively from the Trauma Registry of a level one trauma center, safety-net hospital in New Orleans between 2018 and 2020. Receipt of outpatient PTSD treatment at this same hospital was evaluated via chart review of the electronic health record. Propensity score matching was used to balance confounding variables of trauma type (assault vs. non-assault), gender, and race. McNemar test and Cox proportional hazard model were used with the propensity-balanced dataset to assess differences in trauma recidivism according to PTSD treatment status.
Among 5916 trauma activations that occurred in the study period, 92 instances of recidivism occurred. 91 pairs were established after balancing with the propensity score. 1-year recidivism was 2.2% (n = 2) of all treated individuals versus 15.4% (n = 14) of non-treated individuals (p < 0.0001). The marginal risk from the Cox proportional hazard model demonstrated an 82% reduction in risk of recidivism (p = 0.02).
This study demonstrated that mental health treatment can be used to reduce trauma recidivism. These data were shown among a high-risk population of disproportionately Black men living in a low-income community. Ensuring access to quality mental health care is one way to address the health disparities associated with physically-traumatic injuries.
身体创伤会导致大约 10%的美国人出现创伤后应激障碍（PTSD），而有色人种和贫困人群的这一比例更高。生活在贫困中的有色人种获得 PTSD 和其他心理健康服务的机会较少。未经治疗的 PTSD 与创伤复发的风险增加有关，但尚不清楚提供治疗是否实际上与随后降低复发风险相关。
在这项观察性横断面研究中，数据是从新奥尔良一家一级创伤中心和医疗保障医院的创伤登记处回顾性收集的，时间为 2018 年至 2020 年。通过电子健康记录的图表审查，评估了在同一医院接受门诊 PTSD 治疗的情况。使用倾向评分匹配来平衡创伤类型（攻击型与非攻击型）、性别和种族等混杂变量。使用倾向评分平衡数据集的 McNemar 检验和 Cox 比例风险模型，根据 PTSD 治疗状况评估创伤复发的差异。
在所研究期间发生的 5916 次创伤激活中，有 92 例出现复发。在进行倾向评分匹配后，建立了 91 对。在所有接受治疗的个体中，1 年复发率为 2.2%（n=2），而非治疗组的复发率为 15.4%（n=14）（p<0.0001）。Cox 比例风险模型的边际风险表明，复发风险降低了 82%（p=0.02）。
本研究表明，心理健康治疗可用于降低创伤复发率。这些数据是在一个由高风险的、不成比例的黑人和生活在低收入社区的男性组成的高危人群中得出的。确保获得高质量的心理健康护理是解决与身体创伤相关的健康差异的一种方法。
