Today is the last day of the annual AAST meeting, so I’ll wind up with one last abstract presented at this meeting.
PTSD can cause significant morbidity after trauma. Most centers manage this problem reactively, when the patient exhibits obvious symptoms in the hospital or after discharge. Wouldn’t it make more sense to screen for it routinely? Is there a way to figure out which patients are at higher risk?
The University of Pittsburgh prospectively screened 1,386 injured patients presenting to their followup clinic using the PTSD Checklist – Civilian (PCL-C) instrument. A score of>=35 has a sensitivity of 85% and was considered a positive result.
The authors found that more than 25% of their outpatient clinic patients met the threshold. The most common mechanism was assault, both blunt and penetrating. Younger age (<55), female gender and motor vehicle crash were also found to be predictors.
Bottom line: Consider routine PTSD screening in patients with the listed risk factors, just like we perform routine TBI screening in patients with head injuries. The PCL-C is self-administered and takes only about 5 minutes to complete. The most reliable way is to send it home with your patient, with instructions to complete it before they see you or their primary physician in the outpatient clinic.
Reference: Predictors of post-traumatic stress disorder (PTSD) following civilian trauma: highest incidence and severity of symptoms after assault. AAST 2011 Annual Meeting, Paper 33.