Department of Surgery, Division of Trauma/Critical Care & Acute Surgery, The University of Kansas Health System, 4000 Cambridge St, MS 2005, Kansas City KS 66160.
Department of Surgery, Division of Trauma/Critical Care & Acute Surgery, The University of Kansas Health System, 4000 Cambridge St, MS 2005, Kansas City KS 66160.
Injury. 2022 Oct;53(10):3186-3190. doi: 10.1016/j.injury.2022.07.004. Epub 2022 Jul 21.
Acute Stress Disorder (ASD) is a psychiatric condition affecting individuals exposed to trauma and requires the presence of symptoms 72 h following trauma. Patients evaluated for trauma related injury are often discharged prior to 72 h, but the risk of ASD remains. The aim of this study was to quantify the rate of acute stress disorder in trauma patients admitted for fewer than 72 h.
We performed a prospective, observational study of trauma patients discharged prior to 72 h at our ACS Level I Trauma Center between June 2020 and December 2020. Participants were administered an institutional screening tool following hospital discharge. Positive screens were then administered the diagnostic Acute Stress Disorder Scale (ASDS) tool. The rate of ASD was calculated and bivariate comparisons between participants who met diagnostic criteria and those who did not were performed to identify risk factors for the development of acute stress disorder.
116 patients participated (median age 54, 66% male, median injury severity score (ISS) 9). Forty patients (34%) screened positive via the institutional screening tool, with 14 (12%) ultimately demonstrating ASD by ASDS. Participants who developed ASD were more likely to be female (71 vs. 30%, p = 0.005), African American (43 vs. 12% White, p = 0.016), spend less time in the hospital overall (1-2 vs. 2-3 days. p = 0.045), and have a lower ISS (6 vs. 9, p = 0.041).
Our study found 12% of trauma patients discharged prior to 72 h developed ASD. These data point to possible benefit in reassessment of injured patients following hospital discharge and the importance of developing pathways for trauma patients to access mental health resources.
急性应激障碍（ASD）是一种影响创伤后个体的精神科疾病，需要在创伤后 72 小时内出现症状。评估创伤相关损伤的患者通常在 72 小时前出院，但仍存在 ASD 风险。本研究的目的是量化在 ACS 一级创伤中心住院时间少于 72 小时的创伤患者中急性应激障碍的发生率。
我们对 2020 年 6 月至 2020 年 12 月在我们的 ACS 一级创伤中心住院时间少于 72 小时的创伤患者进行了前瞻性、观察性研究。在出院后，患者接受了机构筛查工具的评估。对阳性筛查者进行了诊断性急性应激障碍量表（ASDS）评估。计算 ASD 的发生率，并对符合和不符合诊断标准的参与者进行了双变量比较，以确定急性应激障碍发展的危险因素。
共有 116 名患者参与（中位数年龄 54 岁，男性占 66%，中位数损伤严重程度评分（ISS）9）。40 名患者（34%）通过机构筛查工具筛查阳性，其中 14 名（12%）通过 ASDS 最终诊断为 ASD。发生 ASD 的患者更可能为女性（71%与 30%，p=0.005），非裔美国人（43%与 12%白人，p=0.016），住院时间总体较短（1-2 天与 2-3 天，p=0.045），ISS 较低（6 与 9，p=0.041）。
我们的研究发现，12%的创伤患者在 72 小时前出院时患有 ASD。这些数据表明，在出院后对受伤患者进行重新评估可能会有所受益，并且为创伤患者获得心理健康资源制定途径非常重要。
