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

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

doi:10.1016/j.injury.2024.112033

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

Injury. 2024 Nov 19;56(2):112033. doi: 10.1016/j.injury.2024.112033. Online ahead of print.

Authors

Miao Qi¹, Weihang Chen², Guojia Qi², Ping Yuan², Xiuli Hu², Jialin Xiang³, Daimin Xiao⁴, Xiangyuan Chu², Xiuquan Shi⁵

Affiliations

¹ 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.
² Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563006, PR China.
³ Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 563000, PR China.
⁴ Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 563000, PR China; Department of Laboratory Medicine, Kweichow Moutai Hospital, Zunyi, Guizhou, 563000, PR China.
⁵ Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou 563006, PR China; Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi, Guizhou, PR China; Center for Pediatric Trauma Research & Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA. Electronic address: xqshi@zmu.edu.cn.

PMID: 39602847
DOI: 10.1016/j.injury.2024.112033

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_Max: 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.

Keywords: ASD; Influencing factors; PTSD; Predictive effect; Trauma.