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Posttraumatic stress disorder in combat casualties with burns sustaining primary blast and concussive injuries.
J Trauma. 2009 Apr; 66(4 Suppl):S178-85.JT

Abstract

BACKGROUND

There is a heightened focus on postexplosion functional outcomes in combat casualties. Previously, we reported a high prevalence of posttraumatic stress disorder (PTSD) (32%) and mild traumatic brain injury (mTBI) (41%) in patients with explosion-related burns. We hypothesized that the prevalence of PTSD in patients with burn was associated with primary blast injuries (PBIs) and mTBI.

METHODS

We reviewed the records of 333 patients admitted consecutively to the United States Army Institute of Surgical Research burn center for explosion-related injuries between March 2003 and March 2006. By using the Posttraumatic Checklist, Military Version (PCL-M), patients were evaluated for PTSD symptoms (PCL-M score >or=44). Loss of consciousness defined mTBI. Patient data were analyzed in groups based on PTSD (yes or no), mechanism of injury (improvised explosive device [IED] vs. other explosive), PBI (yes or no), and mTBI (yes or no).

RESULTS

Of 333 patients, 119 had PTSD assessments. Overall, PTSD was 22% (26 of 119). The prevalence of PTSD differed between mechanism of injury groups (p = 0.03). In the IED group (n = 105), 25% had PTSD symptoms and 18% had mTBI; patients injured by other explosive devices (n = 14) had no PTSD symptoms and one had mTBI (p = 0.04; p = 0.69, respectively). Also in the IED group, in patients with PBI, PTSD was 45% (9 of 20) compared with 20% (17 of 85) without PBI (odds ratio=3.27; 95% confidence interval, 1.17-9.16). More patients with PBI and mTBI (4 of 6; 67%) had PTSD symptoms compared with other patients (22 of 99; 22%) (odds ratio, 7.00; 95% confidence interval, 1.20-40.78). No other associations were found between PBI and mTBI.

CONCLUSION

IED-wounded burn patients with PBI and mTBI have a greater prevalence of PTSD. Patients who did not have IED-related injuries did not have PTSD and only one had mTBI.

Authors+Show Affiliations

United States Army Institute of Surgical Research, Fort Sam Houston, Texas 78234-6315, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19359963

Citation

Mora, Alejandra G., et al. "Posttraumatic Stress Disorder in Combat Casualties With Burns Sustaining Primary Blast and Concussive Injuries." The Journal of Trauma, vol. 66, no. 4 Suppl, 2009, pp. S178-85.
Mora AG, Ritenour AE, Wade CE, et al. Posttraumatic stress disorder in combat casualties with burns sustaining primary blast and concussive injuries. J Trauma. 2009;66(4 Suppl):S178-85.
Mora, A. G., Ritenour, A. E., Wade, C. E., Holcomb, J. B., Blackbourne, L. H., & Gaylord, K. M. (2009). Posttraumatic stress disorder in combat casualties with burns sustaining primary blast and concussive injuries. The Journal of Trauma, 66(4 Suppl), S178-85. https://doi.org/10.1097/TA.0b013e31819ce2d6
Mora AG, et al. Posttraumatic Stress Disorder in Combat Casualties With Burns Sustaining Primary Blast and Concussive Injuries. J Trauma. 2009;66(4 Suppl):S178-85. PubMed PMID: 19359963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Posttraumatic stress disorder in combat casualties with burns sustaining primary blast and concussive injuries. AU - Mora,Alejandra G, AU - Ritenour,Amber E, AU - Wade,Charles E, AU - Holcomb,John B, AU - Blackbourne,Lorne H, AU - Gaylord,Kathryn M, PY - 2009/4/11/entrez PY - 2009/6/12/pubmed PY - 2009/6/26/medline SP - S178 EP - 85 JF - The Journal of trauma JO - J Trauma VL - 66 IS - 4 Suppl N2 - BACKGROUND: There is a heightened focus on postexplosion functional outcomes in combat casualties. Previously, we reported a high prevalence of posttraumatic stress disorder (PTSD) (32%) and mild traumatic brain injury (mTBI) (41%) in patients with explosion-related burns. We hypothesized that the prevalence of PTSD in patients with burn was associated with primary blast injuries (PBIs) and mTBI. METHODS: We reviewed the records of 333 patients admitted consecutively to the United States Army Institute of Surgical Research burn center for explosion-related injuries between March 2003 and March 2006. By using the Posttraumatic Checklist, Military Version (PCL-M), patients were evaluated for PTSD symptoms (PCL-M score >or=44). Loss of consciousness defined mTBI. Patient data were analyzed in groups based on PTSD (yes or no), mechanism of injury (improvised explosive device [IED] vs. other explosive), PBI (yes or no), and mTBI (yes or no). RESULTS: Of 333 patients, 119 had PTSD assessments. Overall, PTSD was 22% (26 of 119). The prevalence of PTSD differed between mechanism of injury groups (p = 0.03). In the IED group (n = 105), 25% had PTSD symptoms and 18% had mTBI; patients injured by other explosive devices (n = 14) had no PTSD symptoms and one had mTBI (p = 0.04; p = 0.69, respectively). Also in the IED group, in patients with PBI, PTSD was 45% (9 of 20) compared with 20% (17 of 85) without PBI (odds ratio=3.27; 95% confidence interval, 1.17-9.16). More patients with PBI and mTBI (4 of 6; 67%) had PTSD symptoms compared with other patients (22 of 99; 22%) (odds ratio, 7.00; 95% confidence interval, 1.20-40.78). No other associations were found between PBI and mTBI. CONCLUSION: IED-wounded burn patients with PBI and mTBI have a greater prevalence of PTSD. Patients who did not have IED-related injuries did not have PTSD and only one had mTBI. SN - 1529-8809 UR - https://www.unboundmedicine.com/medline/citation/19359963/Posttraumatic_stress_disorder_in_combat_casualties_with_burns_sustaining_primary_blast_and_concussive_injuries_ L2 - https://doi.org/10.1097/TA.0b013e31819ce2d6 DB - PRIME DP - Unbound Medicine ER -