枪支伤害幸存者报告称，出院后早期出现身心健康不良后果的风险极高，因此需要多学科护理。
Firearm injury survivors report extreme high risk for poor physical and mental health outcomes early after hospital discharge necessitating multidisciplinary care.
作者信息
Biesboer Elise A, Brandolino Amber, Tomas Carissa W, Johnson Isabel R, deRoon-Cassini Terri, Timmer-Murillo Sydney, Schroeder Mary Elizabeth, DeMoya Marc, Trevino Colleen
机构信息
Department of Surgery, Division of Trauma & Acute Care Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
出版信息
Trauma Surg Acute Care Open. 2025 Jan 19;10(1):e001336. doi: 10.1136/tsaco-2023-001336. eCollection 2025.
BACKGROUND
Up to 20-40% of survivors of any traumatic injury develop post-traumatic stress disorder (PTSD) or depression after injury. Firearm injury survivors may be at even higher risk for adverse outcomes. We aimed to characterize PTSD and depression risk, pain symptoms, and ongoing functional limitations in firearm injury survivors early after hospital discharge.
METHODS
Firearm injury survivors seen in the Trauma Quality of Life (TQOL) outpatient follow-up clinic 1-2 weeks after discharge were invited to participate in a survey assessing both mental and physical health outcomes. The survey included the Brief Pain Inventory (BPI), the Injured Trauma Survivor Screen (ITSS), the Beck Depression Inventory (BDI), the PTSD Checklist for DSM-5 (PCL-5), and the 12-item Short Form Survey Physical Health component (SF-12).
RESULTS
306 patients were seen in the TQOL Clinic, and 175 responded to the survey. The mean age was 32 years (SD=12), 81% were male, and 79% were black. On the ITSS, 69% and 48% of patients screened risk positive for PTSD and depression, respectively. Patients reported mild depression symptoms with an average BDI score of 14.3 (SD=11.8) and elevated PTSD symptoms with an average PCL-5 score of 43.8 (SD=12.8). Patients with severe BPI scores were more likely to screen positive for depression and PTSD. Respondents scored >2 SD below the US national average on the SF-12 for physical quality of life (M=28.7). 12% of patients were at risk across all four domains of pain, PTSD, depression, and physical function.
CONCLUSION
Early after discharge, over two-thirds of firearm injury survivors were at risk for the development of PTSD, nearly half were at risk of depression, and physical function was significantly decreased. Trauma centers need to prioritize early, outpatient multidisciplinary care to treat and prevent the development of poor chronic physical and mental health for firearm injury survivors.
LEVEL OF EVIDENCE
III.
背景
任何创伤性损伤的幸存者中，高达20%-40%的人在受伤后会患上创伤后应激障碍（PTSD）或抑郁症。枪支伤害幸存者出现不良后果的风险可能更高。我们旨在描述出院早期枪支伤害幸存者的PTSD和抑郁症风险、疼痛症状以及持续存在的功能受限情况。
方法
邀请在创伤生活质量（TQOL）门诊随访诊所出院后1-2周就诊的枪支伤害幸存者参与一项评估身心健康结果的调查。该调查包括简明疼痛量表（BPI）、受伤创伤幸存者筛查量表（ITSS）、贝克抑郁量表（BDI）、DSM-5创伤后应激障碍检查表（PCL-5）以及12项简短健康调查量表身体状况部分（SF-12）。
结果
TQOL诊所共诊治了306例患者，175例对调查做出了回应。平均年龄为32岁（标准差=12），81%为男性，79%为黑人。在ITSS量表上，分别有69%和48%的患者筛查出PTSD和抑郁症风险呈阳性。患者报告有轻度抑郁症状，BDI平均得分为14.3（标准差=11.8），PTSD症状升高，PCL-5平均得分为43.8（标准差=12.8）。BPI得分严重的患者更有可能筛查出抑郁症和PTSD呈阳性。在SF-12量表的身体生活质量方面，受访者得分比美国全国平均水平低2个标准差以上（M=28.7）。12%的患者在疼痛、PTSD、抑郁症和身体功能这四个领域均存在风险。
结论
出院早期，超过三分之二的枪支伤害幸存者有患PTSD的风险，近一半有患抑郁症的风险，且身体功能显著下降。创伤中心需要优先提供早期门诊多学科护理，以治疗和预防枪支伤害幸存者出现不良的慢性身心健康问题。
证据级别
III级
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