Gerald Tan, Maritz Laubscher, Sithombo Maqungo, Adam Truss, Kirsty Berry, Nando Ferreira, Simon Matthew Graham
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Patients were screened using the Primary Care PTSD (PC-PTSD-5) screening tool, which is a gold standard measure to identify patients at risk of PTSD in the civilian population. Within this cohort, high-risk patients were assessed with the PTSD checklist (PCL-C), which is a standardized questionnaire scale to indicate if an individual may have PTSD.</p><p><strong>Results: </strong>There were 254 patients in the final cohort analysis with ages ranging from 18 to 71 years, and 75.6% (192/254) of the cohort were male patients. Femoral fractures were found in 51.6% (131/254) of patients while tibial fractures were found in 48.4% (123/254). The rate of PTSD within the study population was found to be 7.1% (18/254), and the risk of developing PTSD was 13.4% (34/254). We did not identify any risk factors, including open fractures, high-injury severity, and complication such as nonunion, for the development of PTSD.</p><p><strong>Conclusions: </strong>This study found the rate of PTSD to be lower compared with that in high-income countries, but still higher than the general population in South Africa. Our study indicates that screening for PTSD in patients with lower limb trauma in LMICs could be beneficial. Early identification of patients at risk of developing PTSD would enable appropriate resources, support, and treatment to be provided.</p><p><strong>Level of evidence: </strong>Level II. 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引用次数: 0
摘要
背景：骨折在低收入和中等收入国家（LMIC）的发生率高得不成比例，通常发生在创伤事件之后。骨折与心理症状发展之间的关系报道不足。本研究的目的是调查南非下肢外伤患者创伤后应激障碍（PTSD）的患病率和危险因素。方法：该研究于2017年9月至2018年12月进行，纳入260例下肢长骨骨折患者。患者使用Primary Care PTSD （PC-PTSD-5）筛查工具进行筛查，这是识别平民人群中有PTSD风险的患者的金标准措施。在该队列中，高危患者使用PTSD检查表（PCL-C）进行评估，这是一种标准化的问卷量表，用于显示个体是否患有PTSD。结果：最终队列分析254例患者，年龄18 ~ 71岁，男性患者占75.6%（192/254）。股骨骨折占51.6%(131/254)，胫骨骨折占48.4%（123/254）。研究人群中PTSD发生率为7.1%(18/254)，发生PTSD的风险为13.4%（34/254）。我们没有发现任何危险因素，包括开放性骨折、高损伤严重程度和并发症，如不愈合，导致PTSD的发生。结论：本研究发现，与高收入国家相比，南非的PTSD发病率较低，但仍高于南非的一般人群。我们的研究表明，对低收入国家下肢创伤患者进行PTSD筛查可能是有益的。早期识别有患PTSD风险的患者可以提供适当的资源、支持和治疗。证据等级：二级。有关证据水平的完整描述，请参见作者说明。
Prevalence & Risk Factors of Post-traumatic Stress Disorder in Patients with Lower Limb Fractures in South Africa.
Background: Fractures occur at disproportionately higher rates in low-income and middle-income countries (LMIC) and commonly occur following a traumatic event. The association between suffering from a fracture and the development of psychological symptoms is under-reported. The aim of this study was to investigate the prevalence and risk factors of developing post-traumatic stress disorder (PTSD) among patients following lower limb trauma in South Africa.
Methods: The study was undertaken from September 2017 to December 2018 and included a cohort of 260 patients with lower limb long bone fractures. Patients were screened using the Primary Care PTSD (PC-PTSD-5) screening tool, which is a gold standard measure to identify patients at risk of PTSD in the civilian population. Within this cohort, high-risk patients were assessed with the PTSD checklist (PCL-C), which is a standardized questionnaire scale to indicate if an individual may have PTSD.
Results: There were 254 patients in the final cohort analysis with ages ranging from 18 to 71 years, and 75.6% (192/254) of the cohort were male patients. Femoral fractures were found in 51.6% (131/254) of patients while tibial fractures were found in 48.4% (123/254). The rate of PTSD within the study population was found to be 7.1% (18/254), and the risk of developing PTSD was 13.4% (34/254). We did not identify any risk factors, including open fractures, high-injury severity, and complication such as nonunion, for the development of PTSD.
Conclusions: This study found the rate of PTSD to be lower compared with that in high-income countries, but still higher than the general population in South Africa. Our study indicates that screening for PTSD in patients with lower limb trauma in LMICs could be beneficial. Early identification of patients at risk of developing PTSD would enable appropriate resources, support, and treatment to be provided.
Level of evidence: Level II. See Instructions for Authors for a complete description of levels of evidence.
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