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Heart rate measured in the acute aftermath of trauma can predict post-traumatic stress disorder: a prospective study in motor vehicle accident survivors.

Abstract

OBJECTIVE

To determine whether increased physiological arousal immediately after trauma or at emergency admission can predict post-traumatic stress disorder (PTSD) in motor vehicle accident (MVA) survivors with physical injuries.

METHODS

We included 119 MVA survivors with physical injuries. In this prospective cohort study, heart rate (HR) and blood pressure (BP) were assessed during ambulance transport (T1) and at hospital admission (T2). One and four months after the accident, we assessed patients for PTSD (Davidson trauma scale, confirmed with the structured clinical interview for DSM-IV axis I disorders). Multivariate logistic regression models assessed the relationship between HR or BP and PTSD.

RESULTS

PTSD was diagnosed in 54 (45.4%) patients at 1 month and in 39 (32.8%) at 4 months. In the multivariate analysis, HR at T1 or at T2 predicted PTSD at 1 month (OR=1.156, 95% CI [1.094;1.221] p<0.0001). Only HR at T1 (not at T2) predicted PTSD at 4 months (OR=1.059, 95% CI [1.013; 1.108] p=0.012). Injury severity predicted PTSD at 4 months (OR=1.207, 95% CI [1.085; 1.342] p=0.001). A cut-off of 84 beats per minute yielded a sensitivity of 62.5% and a specificity of 75.0% for PTSD.

CONCLUSIONS

HR measured at the scene of MVA and severity of injury predicted PTSD 4 months later.

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    MeSH

    Accidents, Traffic
    Adult
    Diagnostic and Statistical Manual of Mental Disorders
    Emergency Medical Services
    Female
    Heart Rate
    Humans
    Male
    Middle Aged
    Predictive Value of Tests
    Prospective Studies
    Stress Disorders, Post-Traumatic
    Survival Analysis
    Survivors
    Trauma Severity Indices
    Wounds and Injuries

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20813504