Symptoms of Posttraumatic Stress Disorder After Orthopaedic Trauma.

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Symptoms of Posttraumatic Stress Disorder After Orthopaedic Trauma.

Starr AJ, WR, Frawley WH, Borer DS, SJ, Reinert CM,

Mendoza-Welch M.

Departments of Orthopaedic Surgery (A.J.S., D.S.B., and C.M.R.) and Academic

Computing (W.H.F.), University of Texas Southwestern Medical Center, 5323

Harry Hines Boulevard, Dallas, TX 75390-8883. E-mail address for A.J. Starr:

adam.starr@.... Department of Orthopaedic Surgery, Denver

Health Medical Center, 777 Bannock Street, MC 0188, Denver, CO 80204-4507.

Department of Trauma Services, Parkland Memorial Hospital, 5201 Harry Hines

Boulevard, Dallas, TX 75235

BACKGROUND: The purpose of this study was to determine the prevalence of

posttraumatic stress disorder among patients seen following an orthopaedic

traumatic injury and to identify whether injury-related or demographic

variables are associated with the disorder. METHODS: Five hundred and eighty

patients who had sustained orthopaedic trauma completed a Revised Civilian

Mississippi Scale for Posttraumatic Stress Disorder questionnaire.

Demographic and injury data were collected to analyze potential variables

associated with posttraumatic stress disorder. RESULTS: Two hundred and

ninety-five respondents (51%) met the criteria for the diagnosis of

posttraumatic stress disorder. Patients with posttraumatic stress disorder

had significantly higher Injury Severity Scores (p = 0.04), a higher sum of

Extremity Abbreviated Injury Scores (p = 0.05), and a longer duration since

the injury than those without posttraumatic stress disorder (p < 0.01).

However, none of these three variables demonstrated a good or excellent

ability to discriminate between patients who had posttraumatic stress

disorder and those who did not. The response to the item, " The emotional

problems caused by the injury have been more difficult than the physical

problems, " was significantly associated with the presence of posttraumatic

stress disorder (p < 0.0001) and showed a fair ability to identify patients

with the disorder. CONCLUSIONS: Posttraumatic stress disorder is common

after orthopaedic trauma. Patients who respond positively to the item, " The

emotional problems caused by the injury have been more difficult than the

physical problems, " may meet diagnostic criteria for this disorder and

should be evaluated further. Level of Evidence: Prognostic study, Level I-1

(prospective study). See Instructions to Authors for a complete description

of levels of evidence.

PMID: 15173282 [PubMed - as supplied by publisher]