The psychological burden of injury: an 18 month prospective cohort study

Mason, Suzanne; Wardrope, J; Turpin, Graham; Rowlands, Alison

doi:10.1136/emj.19.5.400

Cited by 60 publications

(53 citation statements)

References 29 publications

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“…Injury severity was not associated with the development of later psychopathology in the TCOM study (46), similar to previous studies (13,47,48), and thus it appears that those who drop out are neither at high risk nor at low risk for injury-related PTSD. This finding is similar to that of Mason et al and O'Donnell et al who reported shorter hospital stay as a predictor of dropout (15,16), since those with less severe injuries tend to be discharged shortly after MVA. Participants with less severe injury might consider the MVA unimportant and therefore might tend to be indifferent to this kind of follow-up study.…”

Section: Discussionsupporting

confidence: 81%

“…showed that those who dropped out had higher levels of anxiety and depression (16), and Mason et al showed they tend toward psychoticism (15). This apparent contradiction requires elucidation.…”

Section: Objectives Of the Studymentioning

confidence: 99%

“…Recent longitudinal studies of PTSD have included many different groups of subjects, such as exposed disaster workers (1), refugees (2), a community sample (3), survivors of terrorists attacks (4), soldiers hospitalized following serious combat injury (5), patients with myocardial infarction (6), and victims of sexual and physical assault (7). Above all, longitudinal studies of patients following severe injury, especially those involved in motor vehicle accidents (MVAs), comprise one of the largest number of population samples studied (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20).…”

Section: Objectives Of the Studymentioning

confidence: 99%

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Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder?

Nishi

Matsuoka

Nakajima

et al. 2008

Comprehensive Psychiatry

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Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder? Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder? AbstractIn longitudinal studies of traumatic stress, it is particularly important to examine the data for any differences between those who drop out and those who continue to participate, because reluctance to participate might reflect symptoms of avoidance frequently seen in posttraumatic stress disorder (PTSD). However, whether those who drop out are at high risk of PTSD remains unclear. Over a 25-month period, 188 consecutive patients with motor vehicle accident (MVA)-related injuries admitted emergently were enrolled and followed for 4 to 6 weeks. Baseline characteristics were compared between subjects who did and did not participate in the follow-up study. At 4 to 6 weeks, 66 (35.1%) of the participants had dropped out. Bivariate analyses revealed that those who dropped out were likely to be men, alcohol drinkers, smokers, and unconscious just after MVA and to have fewer years of education, less severe injuries, less posttraumatic symptoms, and lower cooperativeness as assessed by the Temperament and Character Inventory. Logistic regression analysis revealed that male sex, unconsciousness during MVA, low cooperativeness, and less severe injuries were significant predictors of dropout. The literature says that male sex and unconsciousness just after MVA might be protective factors against MVA-related PTSD, whereas low cooperativeness is a risk factor for general mental problems. To summarize, it is expected that those who drop from the follow-up are unlikely to have MVA-related PTSD, but might have mental problems independent of injury. In longitudinal studies of traumatic stress, it is particularly important to examine the data for any differences between those who drop out and those who continue to participate, because reluctance to participate might reflect symptoms of avoidance frequently seen in posttraumatic stress disorder (PTSD). However, whether or not those who drop out are at high risk for PTSD remains unclear. Over a 25-month period, 188 TITLE:consecutive patients with motor vehicle accident (MVA)-related injuries admitted emergently were enrolled and followed for 4-6 weeks. Baseline characteristics were compared between subjects who did and did not participate in the follow-up study. At 4-6 weeks, 66 (35.1%) of the participants had dropped out. Bivariate analyses revealed those who dropped out were likely to be men, alcohol drinkers, smokers, unconscious just after MVA, to have fewer years of education, less severe injuries, less posttraumatic symptoms, and lower cooperativeness as assessed by the Temperament and Cognitive

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Section: Discussionsupporting

confidence: 81%

Section: Objectives Of the Studymentioning

confidence: 99%

Section: Objectives Of the Studymentioning

confidence: 99%

See 1 more Smart Citation

Are patients after severe injury who drop out of a longitudinal study at high risk of mental disorder?

Nishi

Matsuoka

Nakajima

et al. 2008

Comprehensive Psychiatry

View full text Add to dashboard Cite

show abstract

“…An alternate hypothesis is that PTSD, which is common in combat casualties, 5 modulates this effect either directly via an inflammatory response 27 or indirectly via weight gain 28 and substance abuse. 6 However, work examining the correlation between ISS and PTSD is conflicting, 29,30 which suggests that this alone cannot account for the differences observed. It is also possible that more severely injured patients have more severe functional limitations resulting in poor outcomes.…”

Section: Iss and Outcomesmentioning

confidence: 99%

Retrospective Analysis of Long-Term Outcomes After Combat Injury

et al. 2015

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We conducted a retrospective cohort study of US service members who sustained combat injuries while deployed in support of military Background-During the conflicts in Iraq and Afghanistan, 52 087 service members have been wounded in combat. The long-term sequelae of these injuries have not been carefully examined. We sought to determine the relation between markers of injury severity and the subsequent development of hypertension, coronary artery disease, diabetes mellitus, and chronic kidney disease. Methods and Results-Retrospective cohort study of critically injured US military personnel wounded in Iraq or Afghanistan from February 1, 2002 to February 1, 2011. Patients were then followed until January 18, 2013. Chronic disease outcomes were assessed by International Classification of Diseases, 9th edition codes and causes of death were confirmed by autopsy. From 6011 admissions, records were excluded because of missing data or if they were for an individual's second admission. Patients with a disease diagnosis of interest before the injury date were also excluded, yielding a cohort of 3846 subjects for analysis. After adjustment for other factors, each 5-point increment in the injury severity score was associated with a 6%, 13%, 13%, and 15% increase in incidence rates of hypertension, coronary artery disease, diabetes mellitus, and chronic kidney disease, respectively. Acute kidney injury was associated with a 66% increase in rates of hypertension and nearly 5-fold increase in rates of chronic kidney disease. Conclusions-In Iraq and Afghanistan veterans, the severity of combat injury was associated with the subsequent development of hypertension, coronary artery disease, diabetes mellitus, and chronic kidney disease.

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“…These propositions are supported by the literature indicating that when psychiatric disorders are co-morbid with traumatic injury, the associated disability is substantial. Many studies, including our own, have uncovered psychiatric disorders (Mason, Wardrope, Turpin, & Rowlands, 2002;Read et al, 2004) and disability after injury (Maraste, Persson, & Berntman, 2003;Smith et al, 2005) and demonstrated that psychiatric morbidity is a major contributor to this disability (Michaels et al, 2000).…”

Section: Introductionmentioning

confidence: 99%