Derivation and Validation of a Brief Emergency Department-Based Prediction Tool for Posttraumatic Stress After Motor Vehicle Collision

被引：1

作者：

Jones, Christopher W. ^{[1
]}

An, Xinming ^{[2
]}

Ji, Yinyao

Liu, Mochuan ^{[3
]}

Zeng, Donglin ^{[3
]}

House, Stacey L. ^{[4
]}

Beaudoin, Francesca L. ^{[5
,6
,7
]}

Stevens, Jennifer S. ^{[8
]}

Neylan, Thomas C. ^{[9
]}

Clifford, Gari D. ^{[10
,11
,12
]}

Jovanovic, Tanja ^{[13
]}

Linnstaedt, Sarah D. ^{[2
]}

Germine, Laura T. ^{[14
,15
,16
]}

Bollen, Kenneth A. ^{[17
,18
]}

Rauch, Scott L. ^{[14
,16
,19
]}

Haran, John P. ^{[20
]}

Storrow, Alan B. ^{[21
]}

Lewandowski, Christopher ^{[22
]}

Musey Jr, Paul I. ^{[23
]}

Hendry, Phyllis L. ^{[24
]}

Sheikh, Sophia ^{[24
]}

Punches, Brittany E. ^{[25
,26
]}

Lyons, Michael S. ^{[25
]}

Kurz, Michael C. ^{[27
,28
]}

Swor, Robert A. ^{[29
]}

McGrath, Meghan E. ^{[30
]}

Hudak, Lauren A. ^{[31
]}

Pascual, Jose L. ^{[32
,33
]}

Seamon, Mark J. ^{[33
,34
]}

Datner, Elizabeth M. ^{[35
,36
]}

Harris, Erica ^{[37
]}

Chang, Anna M. ^{[38
]}

Pearson, Claire ^{[39
]}

Peak, David A. ^{[40
]}

Merchant, Roland C. ^{[41
]}

Domeier, Robert M. ^{[42
]}

Rathlev, Niels K. ^{[43
]}

O'Neil, Brian J. ^{[44
]}

Sergot, Paulina ^{[45
]}

Sanchez, Leon D. ^{[41
,46
]}

Bruce, Steven E. ^{[47
]}

Miller, Mark W. ^{[48
,49
]}

Pietrzak, Robert H. ^{[50
,51
]}

Joormann, Jutta ^{[52
]}

Barch, Deanna M. ^{[53
]}

Pizzagalli, Diego A. ^{[16
,54
]}

Sheridan, John F. ^{[55
,56
]}

Smoller, Jordan W. ^{[57
,58
]}

Harte, Steven E. ^{[59
,60
]}

Elliott, James M. ^{[61
]}

机构：

[1] Rowan Univ, Dept Emergency Med, Cooper Med Sch, Camden, NJ USA

[2] Univ North Carolina Chapel Hill, Inst Trauma Recovery, Dept Anesthesiol, Dept Psychiat, Chapel Hill, NC USA

[3] Univ N Carolina, Dept Biostat, Gillings Sch Global Publ Hlth, Chapel Hill, NC USA

[4] Washington Univ, Dept Emergency Med, Sch Med, St Louis, MO USA

[5] Brown Univ, Rhode Isl Hosp, Alpert Med Sch, Dept Hlth Serv Policy & Practice, Providence, RI USA

[6] Miriam Hosp, Providence, RI USA

[7] Brown Univ, Rhode Isl Hosp, Alpert Med Sch, Dept Emergency Med, Providence, RI USA

[8] Emory Univ, Dept Psychiat & Behav Sci, Sch Med, Atlanta, GA USA

[9] Univ Calif San Francisco, Dept Psychiat & Neurol, San Francisco, CA USA

[10] Emory Univ, Sch Med, Dept Biomed Informat, Atlanta, GA USA

[11] Georgia Inst Technol, Dept Biomed Engn, Atlanta, GA USA

[12] Emory Univ, Atlanta, GA USA

[13] Wayne State Univ, Dept Psychiat & Behav Neurosci, Detroit, MI USA

[14] McLean Hosp, Inst Technol Psychiat, Belmont, MA USA

[15] Many Brains Project, Belmont, MA USA

[16] Harvard Med Sch, Dept Psychiat, Boston, MA USA

[17] Univ North Carolina Chapel Hill, Dept Psychol & Neurosci, Chapel Hill, NC USA

[18] Univ North Carolina Chapel Hill, Dept Sociol, Chapel Hill, NC USA

[19] McLean Hosp, Dept Psychiat, Belmont, MA USA

[20] Univ Massachusetts Med Sch, Dept Emergency Med, Worcester, MA, Brazil

[21] Vanderbilt Univ Sch Med, Dept Emergency Med, Nashville, TN USA

[22] Henry Ford Hlth Syst, Dept Emergency Med, Detroit, MI USA

[23] Indiana Univ Sch Med, Dept Emergency Med, Indianapolis, IN USA

[24] Univ Florida, Dept Emergency Med, Coll Med Jacksonville, Jacksonville, FL USA

[25] Univ Cincinnati, Dept Emergency Med, Coll Med, Cincinnati, OH USA

[26] Univ Cincinnati, Coll Nursing, Cincinnati, OH USA

[27] Univ Alabama Birmingham, Sch Med, Dept Emergency Med, Dept Surg,Div Acute Care Surg, Birmingham, AL USA

[28] Univ Alabama Birmingham, Ctr Injury Sci, Birmingham, AL USA

[29] Oakland Univ, Dept Emergency Med, William Beaumont Sch Med, Rochester, MI USA

[30] Boston Med Ctr, Dept Emergency Med, Boston, MA USA

[31] Emory Univ, Dept Emergency Med, Sch Med, Atlanta, GA USA

[32] Univ Penn, Dept Surg, Dept Neurosurg, Philadelphia, PA USA

[33] Univ Penn, Perelman Sch Med, Philadelphia, PA USA

[34] Univ Penn, Dept Surg Surg Crit Care & Emergency Surg, Div Traumatol, Philadelphia, PA USA

[35] Thomas Jefferson Univ, Dept Emergency Med, Einstein Healthcare Network, Philadelphia, PA USA

[36] Thomas Jefferson Univ, Sidney Kimmel Med Coll, Philadelphia, PA USA

[37] Einstein Med Ctr, Philadelphia, PA USA

[38] Jefferson Univ Hosp, Dept Emergency Med, Philadelphia, PA USA

[39] Wayne State Univ, Ascension St John Hosp, Dept Emergency Med, Detroit, MI USA

[40] Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA USA

[41] Brigham & Womens Hosp, Dept Emergency Med, Boston, MA USA

[42] St Joseph Mercy Hosp, Dept Emergency Med, Ypsilanti, MI USA

[43] Univ Massachusetts Med Sch Baystate, Dept Emergency Med, Springfield, MA USA

[44] Wayne State Univ, Detroit Receiving Hosp, Dept Emergency Med, Detroit, MI USA

[45] Univ Texas Hlth, McGovern Med Sch, Dept Emergency Med, Houston, TX USA

[46] Harvard Med Sch, Dept Emergency Med, Boston, MA USA

[47] Univ Missouri St Louis, Dept Psychol Sci, St Louis, MO USA

[48] Boston Univ, Natl Ctr PTSD, Sch Med, Behav Sci Div,VA Boston Healthcare Syst, Boston, MA USA

[49] Boston Univ, Sch Med, Dept Psychiat, Boston, MA USA

[50] VA Connecticut Healthcare Syst, Natl Ctr PTSD, Clin Neurosci Div, West Haven, CT USA

来源：

ANNALS OF EMERGENCY MEDICINE | 2023年 / 81卷 / 03期

基金：

美国国家卫生研究院;

关键词：

MILITARY SEXUAL TRAUMA; TREATMENT-SEEKING; WAR VETERANS; OLDER-ADULTS; CHRONIC PAIN; SHORT-FORM; DISORDER; PTSD; DISABILITY; PREVALENCE;

D O I：

10.1016/j.annemergmed.2022.08.011

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: To derive and initially validate a brief bedside clinical decision support tool that identifies emergency department (ED) patients at high risk of substantial, persistent posttraumatic stress symptoms after a motor vehicle collision.Methods: Derivation (n=1,282, 19 ED sites) and validation (n=282, 11 separate ED sites) data were obtained from adults prospectively enrolled in the Advancing Understanding of RecOvery afteR traumA study who were discharged from the ED after motor vehicle collision-related trauma. The primary outcome was substantial posttraumatic stress symptoms at 3 months (Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-5 >38). Logistic regression derivation models were evaluated for discriminative ability using the area under the curve and the accuracy of predicted risk probabilities (Brier score). Candidate posttraumatic stress predictors assessed in these models (n=265) spanned a range of sociodemographic, baseline health, peritraumatic, and mechanistic domains. The final model selection was based on performance and ease of administration.Results: Significant 3-month posttraumatic stress symptoms were common in the derivation (27%) and validation (26%) cohort. The area under the curve and Brier score of the final 8-question tool were 0.82 and 0.14 in the derivation cohort and 0.76 and 0.17 in the validation cohort.Conclusion: This simple 8-question tool demonstrates promise to risk-stratify individuals with substantial posttraumatic stress symptoms who are discharged to home after a motor vehicle collision. Both external validation of this instrument, and work to further develop more accurate tools, are needed. Such tools might benefit public health by enabling the conduct of preventive intervention trials and assisting the growing number of EDs that provide services to trauma survivors aimed at promoting psychological recovery. [Ann Emerg Med. 2023;81:249-261.]

引用

页码：249 / 261

页数：13

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