Prevalence, injury-, and non-injury-related factors associated with anxiety and depression in polytrauma patients – A retrospective 20 year follow-up study

Abstract

Introduction Survival rate after polytrauma increased over the past decades resulting in an increase of long-term complaints. These include physical and psychological impairments. The aim of this study was to describe the prevalence and risk factors for developing depression and anxiety more than twenty years after polytrauma. Methods We contacted patients who were treated due to a polytrauma between 1973 and 1990 at one level 1 trauma center after more than 20 years. These patients received a self-administered questionnaire, to assess symptoms of depression and anxiety. Analysis based on multivariable logistic regression models include injury severity and non-injury related factors to determine risk factors associated with the development of depression and anxiety. Results Patients included in this study (n = 337) had a mean ISS of 20.3 (4 to 50) points. In total, 173 (51.3%) showed psychiatric sequelae (depression n = 163, 48.2%; anxiety n = 14, 4.1%). Injury severity was not associated with the development of depression or anxiety. However, the patients, who required psychiatric therapy prior to the injury had higher risk of developing psychiatric symptoms (OR 1.3, 95%CI 1.1 to 1.8, p = 0.018) as did patients who suffered from additional psychiatric insults after the injury (OR 1.4, 95%CI 1.2 to 2.0, p = 0.049).

Systematic Review of the Association Between Trauma Severity and Postinjury Symptoms of Depression

“…The number of per study included patients varied between 32 [ 36 ] and 1,166 [ 20 ]. The mean or median age varied between 25 and 48 years [ 21 , 31 ]. The majority of patients were men (weighted mean 70%; range 56% to 100%).…”

“…Bocci et al [ 36 ] contacted 32 patients between 12 and 24 months after ICU discharge and found no correlation between ISS and HADS. In their study group of severely injured patients (ISS ≥ 16), Halvachizadeh et al [ 37 ] found no statistically significant difference in ISS among patients with HADS < 11 vs ≥ 11 (ISS 21 vs 19) after more than 20 years. Van Delft-Schreurs et al [ 39 ] sent questionnaires by post, which were completed between 15 and 53 months after trauma and also did not find an association (depression measured with HADS).…”

“…The ISS varied widely, due to the inclusion criteria (Table 3). Bocci et al [36], Halvachizadeh et al [37], Jackson et al [38] and van Delft et al [39] only included patients with severe trauma (ISS [ 15). All other studies included both patients with severe trauma (ISS [ 15) and patients with minor injuries (ISS \ 15).…”

Post-traumatic growth in polytraumatized patients after 20+ years: a long-term follow-up study of 337 patients treated at a level 1 trauma center

“…Previous studies from our group have investigated the long-term socio-economic outcomes and psychosocial sequelae of polytrauma in a cohort from a German level one trauma center [6][7][8][9][10][11][12]. Functional impairment, disability, chronic pain, unemployment, financial deficits and psychological sequelae were common among these survivors of polytrauma [11].…”

Recovery After Musculoskeletal Injury: Mental and Social Health

“…We can anticipate that a person who is injured will experience some feelings of worry and despair. 1 We should also consider that people who experience musculoskeletal injury are sometimes involved in risky and even self-destructive behavior that might be associated with feelings of despair, worthlessness, and worry. Consider the impact of unhealthy substance use, 2,3 crime, 4 or risky driving.…”