Highlights
- •Trauma patients are at an elevated risk of developing acute stress disorder and trauma patients discharged prior to 72 h often are not screened.
- •Our study found a significant number of trauma patients discharged in 72 h or less developed acute stress disorder following discharge.
- •Despite injuries requiring shorter hospitalizations, our data supports the reassessment of trauma patients following hospital discharge.
- •Widely accessible pathways need to be developed to increased patient access to mental health resources.
Abstract
Introduction
Acute Stress Disorder (ASD) is a psychiatric condition affecting individuals exposed
to trauma and requires the presence of symptoms 72 h following trauma. Patients evaluated
for trauma related injury are often discharged prior to 72 h, but the risk of ASD
remains. The aim of this study was to quantify the rate of acute stress disorder in
trauma patients admitted for fewer than 72 h.
Materials and Methods
We performed a prospective, observational study of trauma patients discharged prior
to 72 h at our ACS Level I Trauma Center between June 2020 and December 2020. Participants
were administered an institutional screening tool following hospital discharge. Positive
screens were then administered the diagnostic Acute Stress Disorder Scale (ASDS) tool.
The rate of ASD was calculated and bivariate comparisons between participants who
met diagnostic criteria and those who did not were performed to identify risk factors
for the development of acute stress disorder.
Results
116 patients participated (median age 54, 66% male, median injury severity score (ISS)
9). Forty patients (34%) screened positive via the institutional screening tool, with
14 (12%) ultimately demonstrating ASD by ASDS. Participants who developed ASD were
more likely to be female (71 vs. 30%, p = 0.005), African American (43 vs. 12% White, p = 0.016), spend less time in the hospital overall (1–2 vs. 2–3 days. p = 0.045), and have a lower ISS (6 vs. 9, p = 0.041).
Conclusions
Our study found 12% of trauma patients discharged prior to 72 h developed ASD. These
data point to possible benefit in reassessment of injured patients following hospital
discharge and the importance of developing pathways for trauma patients to access
mental health resources.
Keywords
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Article info
Publication history
Published online: July 20, 2022
Accepted:
July 3,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
