McKinnon Anna, Mermin Zoe, Dalgleish Tim, Dixon Clare, Edwards Andrea, Meiser-Stedman Richard, Smith Patrick, Subramanyam Devasena, Boyle Adrian
McKinnon Psychology, Edgecliff, New South Wales, Australia.
Department of Psychology, Princeton, New Jersey, USA.
J Am Coll Emerg Physicians Open. 2025 Jul 8;6(4):100210. doi: 10.1016/j.acepjo.2025.100210. eCollection 2025 Aug.
This study adopted a prospective longitudinal design to assess the utility of demographic and medical characteristics routinely available to emergency medicine clinicians to predict the development of posttraumatic stress disorder (PTSD) in children exposed to death or serious injury 2 months following emergency department (ED) attendance.
A sample of children (8-17 years; N = 231) were recruited from 4 EDs in the East of England between 2010 and 2013. Within 2 weeks of attendance, research nurses screened records for appropriate cases and recorded information on relevant variables from ED attendance notes. At 2 months, a research assistant carried out a structured clinical interview to assess their Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) PTSD symptoms. Univariate analyses were conducted to compare ED characteristics between children who developed PTSD and those who did not. Logistic regression models were used to identify variables associated with increased risk of PTSD.
Ten percent of children met the criteria for PTSD at 2 months. Systolic blood pressure, pulse, number of injuries, being subjected to interpersonal violence, and having a head injury were variables that distinguished PTSD and non-PTSD groups. Logistic regression models showed that being assaulted was predictive of PTSD (Odds ratio = 5.07, 95% CI [1.51, 17.00]); although these models had excellent specificity (0.96), the sensitivity was poor (0.30)-that is, there were a number of cases who developed PTSD but were not assaulted.
PTSD is a complication of exposure to death or injury that occurs in a significant minority of children. Children who are victims of interpersonal violence are more likely to develop the disorder.
本研究采用前瞻性纵向设计，以评估急诊医学临床医生常规可获取的人口统计学和医学特征对于预测在急诊科就诊2个月后遭受死亡或重伤的儿童创伤后应激障碍（PTSD）发生情况的效用。
2010年至2013年期间，从英格兰东部的4个急诊科招募了一组儿童（8 - 17岁；N = 231）。在就诊后2周内，研究护士筛查记录以确定合适的病例，并从急诊科就诊记录中记录相关变量的信息。在2个月时，一名研究助理进行了结构化临床访谈，以评估他们的《精神疾病诊断与统计手册》第五版（DSM - 5）创伤后应激障碍症状。进行单因素分析以比较发生创伤后应激障碍的儿童与未发生者之间的急诊科特征。使用逻辑回归模型来识别与创伤后应激障碍风险增加相关的变量。
10%的儿童在2个月时符合创伤后应激障碍的标准。收缩压、脉搏、受伤数量、遭受人际暴力以及头部受伤是区分创伤后应激障碍组和非创伤后应激障碍组的变量。逻辑回归模型显示，遭受攻击可预测创伤后应激障碍（优势比 = 5.07，95%置信区间[1.51, 17.00]）；尽管这些模型具有出色的特异性（0.96），但敏感性较差（0.30）——也就是说，有一些发生创伤后应激障碍的病例并未遭受攻击。
创伤后应激障碍是接触死亡或受伤后的一种并发症，在相当一部分儿童中发生。人际暴力受害者儿童更易患此病。
