Background: Psychological consequences such as post-traumatic stress disorder (PTSD) are currently neglected in burden-of-injury calculations.
Aim: To assess the disease burden of PTSD due to unintentional injury and compare this health loss with physical injury consequences.
Methods: From literature sources, the prevalence of PTSD at four follow-up periods (<3 months, 3-6 months, 7-12 months and >12 months) was estimated. The uncertainty of the estimated PTSD prevalence was modelled by a Bayesian approach. The prevalence rates were then linked to national data on unintentional injury, disability weights and duration to estimate the incidence and disability-adjusted life years (DALY) resulting from PTSD in addition to physical injury consequences.
Results: The data suggest that PTSD prevalence among injury victims decreases over time. The average PTSD prevalence at <3 months follow-up was 21% (90% credibility interval (CI) 17% to 24%) for patients presenting at the emergency department and 30% (90% CI 27% to 33%) for patients who were hospitalised, tapering down after 12 months to 4% (90% CI 3% to 5%) and 6% (90% CI 4% to 10%), respectively. These estimates translate into 191,000 (90% CI 161,000 to 222,000) cases of PTSD per year in the Dutch population (1.2%) due to unintentional injury. Including PTSD increases the non-fatal burden of disease of unintentional injuries by 53% (from 116,000 to 178,000 DALYs (90% CI 150,000 to 217,000)).
Conclusions: Ignoring PTSD in burden-of-injury studies results in a considerable underestimation of the burden of injury. This may affect resource allocation and the identification of important prevention priorities.