• Timothy F Platts-Mills, Bo C Nebolisa, Sean A Flannigan, Natalie L Richmond, Robert M Domeier, Robert A Swor, Phyllis L Hendry, David A Peak, Niels K Rathlev, Jeffrey S Jones, David C Lee, Christopher W Jones, and Samuel A McLean.
• Department of Anesthesiology, University of North Carolina, Chapel Hill, NC; Department of Emergency Medicine, University of North Carolina, Chapel Hill, NC. Electronic address: tplattsm@med.unc.edu.
• Am J Geriatr Psychiatry. 2017 Sep 1; 25 (9): 953-963.

ObjectiveTo characterize risk factors for and consequences of post-traumatic stress disorder (PTSD) among older adults evaluated in the emergency department (ED) following motor vehicle collision (MVC).DesignProspective multicenter longitudinal study (2011-2015).Setting9 EDs across the United States.ParticipantsAdults aged 65 years and older who presented to an ED after MVC without severe injuries.MeasurementsPTSD symptoms were assessed 6 months after the ED visit using the Impact of Event Scale-Revised.ResultsOf 223 patients, clinically significant PTSD symptoms at 6 months were observed in 21% (95% CI 16%-26%). PTSD symptoms were more common in patients who did not have a college degree, had depressive symptoms prior to the MVC, perceived the MVC as life-threatening, had severe ED pain, and expected their physical or emotional recovery time to be greater than 30 days. Three factors (ED pain severity [0-10 scale], perceived life-threatening MVC [0-10 scale], and pre-MVC depressive symptoms [yes to either of two questions]), predicted 6-month PTSD symptoms with an area under the curve of 0.76. Compared to patients without PTSD symptoms, those with PTSD symptoms were at higher risk for persistent pain (72% versus 30%), functional decline (67% versus 42%), and new disability (49% versus 18%).ConclusionsAmong older adults treated in the ED following MVC, clinically significant PTSD symptoms at 6 months were present in 21% of patients and were associated with adverse health outcomes. Increased risk for PTSD development can be identified with moderate accuracy using information readily available in the ED.Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

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