Factors associated with posttraumatic stress symptoms in a prospective cohort of patients after abdominal sepsis: a nomogram

Abstract

Objective To determine to what extent patients who have survived abdominal sepsis suffer from symptoms of posttraumatic stress disorder (PTSD) and depression, and to identify potential risk factors for PTSD symptoms. Design and setting PTSD and depression symptoms were measured using the Impact of Events Scale–Revised (IES-R), the Post-Traumatic Symptom Scale 10 (PTSS-10) and the Beck Depression Inventory II (BDI-II). Patients and participants A total of 135 peritonitis patients were eligible for this study, of whom 107 (80%) patients completed the questionnaire. The median APACHE-II score was 14 (range 12–16), and 89% were admitted to the ICU. Measurements and results The proportion of patients with “moderate” PTSD symptom scores was 28% (95% CI 20–37), whilst 10% (95% CI 6–17) of patients had “high” PTSD symptom scores. Only 5% (95% CI 2–12) of the patients expressed severe depression symptoms. Factors associated with increased PTSD symptoms in a multivariate ordinal regression model were younger age (0.74 per 10 years older, p = 0.082), length of ICU stay (OR = 1.4 per doubling of duration, p = 0.003) and having some (OR = 4.9, p = 0.06) or many (OR = 55.5, p < 0.001) traumatic memories of the ICU or hospital stay. Conclusion As many as 38% of patients after abdominal sepsis report elevated levels of PTSD symptoms on at least one of the questionnaires. Our nomogram may assist in identifying patients at increased risk for developing symptoms of PTSD. Electronic supplementary material The online version of this article (doi:10.1007/s00134-007-0941-3) contains supplementary material, which is available to authorized users.

Health-Related Quality of Life and the Prevalence of Post-Traumatic Stress Disorder among Crimean-Congo Hemorrhagic Fever Survivors

“…Among survivors of many life threatening infectious diseases, psychiatric morbidities were observed (6)(7)(8)(9)12). Similar to CCHF, SARS is an infectious disease that has an acute course, but it is not chronic in process.…”

“…Moreover, quarantine duration was correlated with PTSD symptoms (16). In addition to CCHF and SARS, Legionella pneumonia and abdominal sepsis are fatal infectious diseases that have been reported to have psychiatric morbidities (6,12). In a study conducted on legionellosis 17 months after the disease, it was reported that 15z of survivors had PTSD, whereas only one patient sought medical help (6).…”

Posttraumatic Stress in Older Adults

“…Although studies vary as to whether age [2][3][4] increases risk for medically induced PTSD, several other factors are consistently associated with increased risk (Box 1). 2,[4][5][6] Box 1…”

Parents’ perceptions of genetics services for congenital heart disease: the role of demographic, clinical, and psychological factors in determining service attendance

“…Elevated and probable posttraumatic stress levels were defined as IES-R total scores above 24 and 32, respectively. 23,24 8. Information-seeking style (32 items): According to the monitoring process model, the way people cope under situations of threat can be classified as either cognitive confrontation ("high monitoring") or cognitive avoidance ("low monitoring").…”