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急性应激障碍对创伤后应激障碍的预测作用以及影响急性应激障碍和创伤后应激障碍的因素。

The predictive effect of ASD on PTSD and the factors influencing ASD and PTSD.

作者信息

Qi Miao, Chen Weihang, Qi Guojia, Yuan Ping, Hu Xiuli, Xiang Jialin, Xiao Daimin, Chu Xiangyuan, Shi Xiuquan

机构信息

Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563006, PR China; Wanzhou District Center for Disease Control and Prevention, Wanzhou, Chongqing 404100, PR China.

Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563006, PR China.

出版信息

Injury. 2025 Feb;56(2):112033. doi: 10.1016/j.injury.2024.112033. Epub 2024 Nov 19.

Abstract

OBJECTIVE

To investigate the prevalence and influencing factors of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) in trauma patients, and to explore the predictive effect of ASD on PTSD.

METHODS

A prospective study was conducted on patients hospitalized due to injuries. The first survey used the ASD scale to assess the occurrence of ASD. In one month and three months of follow-up after injury, patients were assessed for the occurrence of PTSD by using the PTSD checklist-civilian version.

RESULTS

The prevalence rates of ASD, one-month PTSD, and three-month PTSD in trauma inpatients were 20.7%, 19.5%, and 17.6%, respectively. ASD is a strong predictor of PTSD, and combining it with severe injury and critical illness can improve the sensitivity and positive predictive ability of predicting the occurrence of PTSD (AUC: 0.827). The important predictive factor for the diagnosis of PTSD is the high alert symptom group of ASD. Moreover, the analysis results showed that the season of trauma happened, comatose state, fear state, psychological burden, and pain intensity were the influencing factors for ASD (P<0.05), while critical illness during hospitalization, psychological burden, and pain intensity were the influencing factors for PTSD (P<0.05).

LIMITATIONS

Some patients with minor and extremely serious injuries were overlooked or missed, resulting in selection bias and information bias that could not be completely avoided.

CONCLUSION

Both trauma conditions and clinical features may affect the occurrence of ASD and PTSD in trauma patients. If ASD in trauma patients is identified early and targeted interventions, it may reduce the occurrence and development of PTSD.

摘要

目的

探讨创伤患者急性应激障碍(ASD)和创伤后应激障碍(PTSD)的患病率及影响因素,并探究ASD对PTSD的预测作用。

方法

对因伤住院患者进行前瞻性研究。首次调查采用ASD量表评估ASD的发生情况。在受伤后1个月和3个月的随访中,使用PTSD检查表平民版评估患者PTSD的发生情况。

结果

创伤住院患者中ASD、1个月PTSD和3个月PTSD的患病率分别为20.7%、19.5%和17.6%。ASD是PTSD的有力预测指标,将其与重伤和危重症相结合可提高预测PTSD发生的敏感性和阳性预测能力(AUC:0.827)。ASD的高警觉症状组是诊断PTSD的重要预测因素。此外,分析结果显示,创伤发生季节、昏迷状态、恐惧状态、心理负担和疼痛强度是ASD的影响因素(P<0.05),而住院期间的危重症、心理负担和疼痛强度是PTSD的影响因素(P<0.05)。

局限性

一些轻伤和极重伤患者被遗漏或未纳入,导致无法完全避免选择偏倚和信息偏倚。

结论

创伤情况和临床特征均可能影响创伤患者ASD和PTSD的发生。若早期识别创伤患者的ASD并进行针对性干预,可能会减少PTSD的发生和发展。

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