Post-traumatic stress symptoms in relatives in the first weeks after severe traumatic brain injury

Abstract

Introduction: Severe traumatic brain injury (STBI) can cause psychological stress in proxies in the long-term. This study assessed post-traumatic stress (PTS) symptoms in proxies of survivors of STBI in the short-term and investigated stress-associated factors.Methods: Prospective cross-sectional study, conducted at three Swiss trauma centres over 1 year. Patient and proxy demographics, trauma data including Glasgow Coma Scale (GCS) and management data were collected. The proxies’ PTS symptoms were assessed by applying the Impact of Event Scale–Revised (IES-R), once in the first month after the accident (median: 11 days).Results: Sixty-nine proxies were included; 52 proxies were female (77.8%). Mean IES-R sum score for intrusions was 13.38 (SD = 7.26), for avoidance 8.91 (SD = 5.94), and for hyperarousal 9.07 (SD = 6.75). Clinically significant PTS symptoms were observed in 36 proxies (52.2%); mean IES-R sum scores were significantly higher in women. IES-R sub-scale values were inversely related with GCS at the scene of the accident and on hospital admission.Conclusions: More than half of proxies had clinically significant PTS symptoms shortly after their relative's accident. More severe PTS symptoms were found in women and in proxies of patients with poorer initial GCS scores. Further research into risk groups in the short- and long-term and the long-term impact on patients of PTS syndrome in proxies is warranted.