Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
Department of Surgery, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA.
Burns. 2024 Apr;50(3):561-568. doi: 10.1016/j.burns.2023.12.016. Epub 2024 Jan 12.
Post-traumatic stress disorder (PTSD) afflicts a significant portion of burn patients. This study aims to analyze the morbidity, prevalence, and treatment of PTSD in the burn population.
Using the TriNetX database, we identified burned patients > 18 years of age without (A) or with (B) a PTSD diagnosis. Patients were then stratified by percent of total body surface area (TBSA) burned. Morbidity and mortality was analyzed in each cohort. Prevalence and pharmacologic treatments for PTSD were analyzed from 2002 to 2022.
PTSD incidence increased from 2.4% (n = 2281) in patients with < 10% to 3.1% (n = 542) in 10-30%, 7.4% (n = 285) in 30-59%, and 5.3% (n = 90) in > 60% TBSA burned. In patients with < 60% TBSA burned, PTSD diagnosis increased the risk of depression (p = <0.0003) and anxiety (p = <0.0001). In those with < 30% TBSA burned, PTSD diagnosis also increased risk of insomnia (p = <0.0001) and pruritus (p = 0.0211 for TBSA <10% and 0.0059 for TBSA 10-29%). PTSD diagnosis was associated with a decreased risk of mortality in patients with > 30% TBSA burned (p = 0.0179 for TBSA 30-59% and p = 0.0089 for TBSA >60%). From 2002 to 2022, the prevalence of PTSD in all burn patients was relatively stable between 2.2% and 3.2%. We found an increase in the use of serotonergic agents and prazosin for the treatment of PTSD during this timeframe.
PTSD is not uncommon in the burn population, and those with burns and concomitant PTSD have an increased risk of morbidity. Screening and preventative measures to reduce morbidity and early implementation of care in burned patients with PTSD are indicated.
创伤后应激障碍（PTSD）影响了很大一部分烧伤患者。本研究旨在分析烧伤人群中 PTSD 的发病率、患病率和治疗情况。
我们使用 TriNetX 数据库，确定了年龄大于 18 岁的烧伤患者，分为无（A）或有（B）PTSD 诊断的患者。然后按总体表烧伤面积（TBSA）的百分比将患者分层。分析了每个队列的发病率和死亡率。分析了 2002 年至 2022 年 PTSD 的患病率和药物治疗情况。
PTSD 的发病率从 TBSA 烧伤面积＜10%的患者中 2.4%（n=2281）增加到 TBSA 烧伤面积 10-30%的患者中 3.1%（n=542），TBSA 烧伤面积 30-59%的患者中 7.4%（n=285），TBSA 烧伤面积＞60%的患者中 5.3%（n=90）。在 TBSA 烧伤面积＜60%的患者中，PTSD 诊断增加了抑郁（p＜0.0003）和焦虑（p＜0.0001）的风险。在 TBSA 烧伤面积＜30%的患者中，PTSD 诊断也增加了失眠（p＜0.0001）和瘙痒（TBSA＜10%时 p=0.0211，TBSA 10-29%时 p=0.0059）的风险。在 TBSA 烧伤面积＞30%的患者中，PTSD 诊断与死亡率降低相关（TBSA 烧伤面积 30-59%时 p=0.0179，TBSA 烧伤面积＞60%时 p=0.0089）。从 2002 年到 2022 年，所有烧伤患者中 PTSD 的患病率在 2.2%至 3.2%之间相对稳定。在此期间，我们发现用于治疗 PTSD 的 5-羟色胺能药物和普萘洛尔的使用有所增加。
PTSD 在烧伤人群中并不少见，且伴有 PTSD 的烧伤患者发病率更高。提示对烧伤患者进行 PTSD 筛查和预防措施以降低发病率，并在烧伤伴 PTSD 的患者中早期实施治疗。
