Prevalence and risk factors for acute stress disorder and posttraumatic stress disorder after burn injury

Abstract

BackgroundPsychological consequences of burn injury can be profound. Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are known sequelae, but routine identification is challenging. This study aims to identify patient characteristics associated with outpatient positive screens. MethodsThe Primary Care Posttraumatic Stress Disorder questionnaire (PC-PTSD-4) was administered at initial outpatient Burn Center visits between 5/2018–12/2018. Demographics, injury mechanism, and total body surface area (TBSA) were recorded. Those with ≥3 affirmative answers were considered positive. Patients with positive and negative screens were compared. ResultsOf 307 surveys collected, 292 (median TBSA 1.5 %, IQR 0.5–4.0 %) remained for analysis after exclusions. Of those, 24.0 % screened positive. Positive screens were associated with presence of a deep component of the injury, injury mechanism, upper extremity involvement, ICU admission, and prolonged hospital length of stay. ConclusionsNumerous factors distinguish burn injury from other traumatic mechanisms and contribute to disproportionate rates of traumatic stress disorders. Optimization of burn-oriented ASD and PTSD screening protocols can enable earlier intervention.