Progress in Characterizing Anatomic Injury

SummaryBackground: Decreased activation of the hypothalamus-pituitary-adrenal (HPA) axis in response to stress is suspected to be a vulnerability factor for posttraumatic stress disorder (PTSD). Previous studies showed inconsistent findings regarding the role of cortisol in predicting PTSD. In addition, no prospective studies have examined the role of dehydroepiandrosterone (DHEA), or its sulfate form DHEAS, and the cortisol-to-DHEA(S) ratio in predicting PTSD. In this study, we tested whether acute plasma cortisol, DHEAS and the cortisol-to-DHEAS ratio predicted PTSD symptoms at 6 weeks and 6 months post-trauma. Methods: Blood samples of 397 adult level-1 trauma center patients, taken at the trauma resuscitation room within hours after the injury, were analyzed for cortisol and DHEAS levels. PTSD symptoms were assessed at 6 weeks and 6 months post-trauma with the Clinician Administered PTSD Scale. Results: Multivariate linear regression analyses showed that lower cortisol predicted PTSD symptoms at both 6 weeks and 6 months, controlling for age, gender, time of blood sampling, injury, trauma history, and admission to intensive care. Higher DHEAS and a smaller cortisol-to-DHEAS ratio predicted PTSD symptoms at 6 weeks, but not after controlling for the same variables, and not at 6 months. Conclusions: Our study provides important new evidence on the crucial role of the HPA-axis in response to trauma by showing that acute cortisol and DHEAS levels predict PTSD symptoms in survivors of recent trauma. #

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“…The ISS ranges from 0 (no injury) to 75 (unsurvivable injury) with a score of 16 and higher indicating severe injury (Copes et al, 1990). …”

Section: Injury-related Characteristicsmentioning

confidence: 99%

The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms

Mouthaan

Sijbrandij²,

Luitse

et al. 2014

Psychoneuroendocrinology

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“…The Injury Severity Score (ISS) [18] was computed after all injuries had been identified using the Abbreviated Injury Scale 90 reference book. [19] Death or survival was ascertained from the electronic hospital discharge notes.…”

Section: Researchmentioning

confidence: 99%

Elevated international normalised ratios correlate with severity of injury and outcome

Noorbhai

Cassimjee²,

Sartorius

et al. 2016

S Afr Med J

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“…Its value in the current study is to examine the cost of nonfatal injuries in addition to the cost of fatal injuries regarding ATV-related incident trauma [18]. The AIS is assigned in the trauma centers to reflect anatomically-based injury severity with six rankings: (1) minor; (2) moderate; (3) serious; (4) severe; (5) critical; and (6) not survivable (dead) [19]. This scoring reflects the threat to life.…”

Section: Injury Severity Scalesmentioning

confidence: 99%

Potential Benefit of the Quadbar™ on All-Terrain Vehicles

Myers

2016

Safety

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An epidemic exists related to all-terrain vehicle (ATV) fatal and nonfatal injuries in the United States and in Australia as well as in other countries. More than 60% of these injuries are associated with ATV overturns. While behavior-related methods have failed to abate this epidemic, engineered interventions have been lacking. However, one technology, the Quadbar™ (QB), shows promise as a crush prevention device for reducing overturn-related injuries and their severity. The question addressed in this study is "What is the potential public health and economic benefit of the QB when used on ATVs?" At 40% effectiveness, our model estimated that 5082 injuries related to ATV overturns would be prevented per 100,000 ATVs equipped with QBs. The overall societal economic benefit was estimated at US$3,943 per ATV that greatly exceeds the QB purchase price of US$478, which represents an 8:1 return on investment.

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Progress in Characterizing Anatomic Injury

Cited by 245 publications

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The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms

The role of acute cortisol and DHEAS in predicting acute and chronic PTSD symptoms

Elevated international normalised ratios correlate with severity of injury and outcome

Potential Benefit of the Quadbar™ on All-Terrain Vehicles

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