Post-traumatic Stress Symptoms in a Violently Injured Civilian Population: A Need for Hospital Identification and Resources

Abstract

ABSTRACT Background Post-traumatic stress disorder (PTSD) has become a recognized healthcare crisis. Urban trauma centers (UTC) treat a high rate of violently injured patients, a known risk factor for PTSD. A quality improvement (QI) project related to PTSD was implemented to assess the prevalence of PTSD symptomology post-discharge and the need for inpatient screening and referral. Study design In 2013, 3,525 patients were admitted to a UTC, of which 560 suffered a violent injury. One hundred and twentysix (23%) were provided PTSD education and offered resources for mental health treatment (MHT). Patients in police custody, with self-inflicted injuries, with injuries related to domestic violence, or who were non-English speaking were not included in the QI analysis (37%). At 4 to 6 weeks post-discharge, patients were contacted and administered a four item PTSD screening tool. Referral to MHT was offered and provided if requested. Results One hundred and twenty-six patients were evaluated. Sixty-four (51%) patients were reached at 4 to 6 weeks postdischarge and 60 (48%) completed the full 4-item tool. Fifty (78%) had GSW, 7 (11%) had stab wounds, and 7 (11%) had assault. Sixty-two percent reported experiencing at least one major symptom of PTSD, and 52% experienced >2 major symptoms. Eighty-seven percent of patients who developed symptoms of PTSD refused referrals pre-discharge. Post-discharge, patients with at least one PTSD symptom (37) requested MHT at a significantly higher rate than those without symptoms (23; p = < 0.0001). Patients with 3 to 4 symptoms requested referral information at a higher rate than those with 0 to 2 symptoms (p ≤0.0001). Conclusion Violently injured patients are at risk for the development of PTSD symptoms post-discharge. Trauma centers have a unique opportunity to implement PTSD screening, referral and post-discharge follow-up to effect change for this at-risk population. How to cite this article Jordan A, Goldberg S, Bivins J, Hogue B, Wolfe L, Aboutanos MB. Post-traumatic Stress Symptoms in a Violently Injured Civilian Population: A Need for Hospital Identification and Resources. Panam J Trauma Crit Care Emerg Surg 2015;4(2):54-58.