Citation

Hunt JC, Herrera-Hernandez E, Brandolino A, Jazinski-Chambers K, Maher K, Jackson B, Smith RN, Lape D, Cook M, Bergner C, Schramm AT, Brasel KJ, de Moya MA, deRoon-Cassini TA. J. Trauma Acute Care Surg. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000003079

PMID

unavailable

Abstract

BACKGROUND: Psychological distress is common following a traumatic injury event. The Injured Trauma Survivor Screen (ITSS) was developed at a Level 1 trauma center to assess for posttraumatic stress disorder (PTSD) and major depressive episode (MDE) following admission for a traumatic injury. The ITSS sensitivity and specificity were analyzed 1-3 and 6-9 months post-injury to test the validity across trauma centers.

METHOD: Four Level 1 trauma centers from the East, Midwest, South and West in the United States recruited 375 eligible adult inpatients. (Excluded participants included those with moderate or severe TBI, whose injury was self-inflicted, were non-communicative, or were non-English speaking.) Baseline sample (63.2% White/Caucasian, 62.4% male, mean age = 45 (17.11) years, 42.4% injured by motor vehicle collision) measurements were conducted during index hospitalization. At first follow-up, 69.6% (N = 261) were retained; at second follow-up, 61.3% (N = 230) were retained. Measurements included the ITSS, PTSD Checklist for DSM-5 (PCL-5), Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and Clinician-Administered PTSD Scaled for DSM 5 (CAPS-5).

RESULTS: At follow-up 1 the ITSS PTSD subscale had a sensitivity of 75% and specificity of 78.8% and the MDE subscale had a sensitivity of 80.4% and specificity 65.6%. At follow-up two, the PTSD subscale had a sensitivity of 72.7% and specificity of 83.1% and the MDE subscale had a sensitivity of 76.1% and specificity 68.3%. A combined risk group using two symptom based measures administered at baseline produced increased specificity.

CONCLUSIONS: The 9-item ITSS continues to be an efficient and effective risk screen for PTSD and MDE following traumatic injury requiring hospitalization. This multi-institutional validation study creates a solid foundation for further exploration of the generalizability of this screen's psychometric properties in distinct populations.Prognostic Study, Evidence Level III.

Language: en