Talmy Tomer, Bulis Shir, Radomislensky Irina, Bushinsky Shir, Tsur Nir, Gelman Daniel, Paulman Omer, Gendler Sami, Tsur Avishai M, Almog Ofer, Benov Avi
Israel Defense Forces Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.
Department of Military Medicine, Faculty of Medicine, Hebrew University, Jerusalem, Israel.
J Trauma Stress. 2025 Feb;38(1):135-145. doi: 10.1002/jts.23110. Epub 2024 Oct 25.
Posttraumatic stress disorder (PTSD) often occurs following mass casualty events, yet the connection between the number of individuals injured in an event and PTSD risk in smaller-scale events (i.e., involving one or several injured persons) remains unclear. We conducted a registries-based study cross-referencing three databases across the continuum of care for military trauma patients hospitalized for traumatic injuries. The study population was categorized into three groups based on the number of injured individuals involved (i.e., single injured person, two to four [2-4] injured people, and five or more [≥ 5] injured people), and PTSD prevalence was assessed using long-term disability claim diagnoses. Overall, 4,030 military personnel were included (age at injury: Mdn = 20 years), and 18.3% were subsequently diagnosed with PTSD, with the highest prevalence in events involving ≥ 5 injured individuals (35.8%). Regression analyses adjusted for potential confounders revealed that being injured in an event with 2-4 injured persons, OR = 1.68, 95% CI [1.31, 2.15], or ≥ 5 injured persons, OR = 2.36, 95% CI [1.79, 3.13], was associated with increased odds of developing PTSD compared to being the sole injured person. The findings suggest a direct association between the number of injured individuals in an event and PTSD prevalence among traumatic injury survivors. The results underscore the importance of early diagnosis and interventions to prevent PTSD in individuals injured in multicasualty and mass casualty events.
创伤后应激障碍(PTSD)常发生在重大伤亡事件之后,但在小规模事件(即涉及一两名或数名伤者)中,事件中受伤人数与PTSD风险之间的联系仍不明确。我们进行了一项基于登记处的研究,对三个数据库进行交叉引用,这些数据库涵盖了因创伤性损伤住院的军事创伤患者的连续护理过程。根据所涉及的受伤人数,将研究人群分为三组(即单名伤者、两至四名伤者和五名或更多伤者),并使用长期残疾索赔诊断来评估PTSD患病率。总体而言,纳入了4030名军事人员(受伤时年龄:中位数 = 20岁),随后有18.3%被诊断患有PTSD,在涉及≥5名伤者的事件中患病率最高(35.8%)。对潜在混杂因素进行调整后的回归分析显示,与仅为唯一伤者相比,在有两至四名伤者的事件中受伤,优势比(OR)= 1.68,95%置信区间(CI)[1.31, 2.15],或在有≥5名伤者的事件中受伤,OR = 2.36,95% CI [1.79, 3.13],与患PTSD的几率增加相关。研究结果表明,事件中受伤人数与创伤性损伤幸存者的PTSD患病率之间存在直接关联。结果强调了早期诊断和干预对于预防在多人伤亡和重大伤亡事件中受伤个体发生PTSD的重要性。