Articles: trauma.
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Meta Analysis
Epidemiology of Post-traumatic Stress Disorder in Iranian Population From 2019 to 2024: A Systematic Review and Meta-analysis.
Post-traumatic stress disorder (PTSD) is a disorder that arises from experiencing traumatic events such as traffic accidents, war, natural disorders, and job incidents. This study focused on determining the epidemiology of PTSD in the Iranian population from 2019 to 2024. ⋯ The prevalence of PTSD in young Iranian men is relatively high, and there was no statistically significant decrease in PTSD prevalence between 2019 and 2024.
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Critical care clinics · Oct 2024
ReviewDisparities in Access, Management and Outcomes of Critically Ill Adult Patients with Trauma.
Despite legal protections guaranteeing care for patients with trauma, disparities exist in patient outcomes. We review disparities in patient management and outcomes related to insurance status, race and ethnicity, and gender for patients with trauma in the preadmission, in-hospital, and postdischarge settings. We highlight groups understudied and either underrepresented or unrepresented in national trauma databases-including American Indians/Alaska Natives, non-English preferred patients, and patients with disabilities. We call for more study of these groups and of upstream factors affecting the reviewed demographics to measure and improve outcomes for these vulnerable populations.
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Adverse childhood experiences (ACEs) affect approximately half of all children worldwide. These experiences have been linked to increased pain sensitivity in adulthood and a higher likelihood of developing severe chronic pain. However, most studies have assessed the effects of ACEs retrospectively, long after they occurred, leaving room for other factors to influence the observed outcomes. ⋯ Children with higher PTSS severity displayed pain hypersensitivity regardless of their traumatic exposure level, whereas in children with lower PTSS severity, greater traumatic exposure correlated with pain hypersensitivity. The results suggest that ACEs among children lead to concurrent pain hypersensitivity and distress and may put them at elevated risk of chronic pain early in life. In addition, our findings emphasize the need for identifying children with various PTSS levels to provide tailored interventions and mitigate the long-term negative effects of ACEs.
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Post-traumatic stress disorder (PTSD) is common in patients with chronic pain, adversely affects chronic pain outcomes, and is associated with opioid use and adverse opioid outcomes. Social support is a robust predictor of PTSD incidence and course as well as chronic pain outcome. We determined whether the association between PTSD and persistent opioid use was modified by emotional support in a cohort of patients receiving opioids for noncancer pain. ⋯ In fully adjusted models, PTSD was no longer associated with opioid use at 6-month follow-up among participants with high emotional support. Among those with lower emotional support, PTSD was significantly associated with opioid use at 6-month follow-up in unadjusted (odds ratio = 2.40; 95% confidence interval: 1.24-4.64) and adjusted models (odds ratio = 2.39; 95% confidence interval: 1.14-4.99). Results point to the hypothesis that improvement of emotional support in vulnerable patients with chronic pain and PTSD may help reduce sustained opioid use.
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Eur J Trauma Emerg Surg · Oct 2024
Comparative Study Observational StudyComparison of whole body computed tomography findings with physician predictions in high-energy blunt trauma patients: prospective observational study.
The whole-body computed tomography (WBCT) procedure is increasingly common in evaluating patients presenting with high-energy trauma. However, it remains unclear in which population WBCT provides benefit and whether its routine application is truly beneficial. In this study, we aimed to compare physician predictions with WBCT findings in patients with high-energy blunt trauma. ⋯ The study included a total of 92 patients. The median age was 27 years (IQR 25-75; 20-54). Among the patients, 27 (%) had life-threatening injuries according to CT findings in any region. A total of 34 (37%) patients were predicted by physicians to have "no pathology" in all three regions. Among these patients, none had life-threatening pathology in all three regions. There were 10 (10.9%) patients with CT findings more severe than physician predictions in at least one region. The sensitivity of physician predictions for life-threatening injury to the head/cervical region was 94.1% (95% CI: 71.3-99.9). For life-threatening injury to the chest, the sensitivity was 85.7% (95% CI: 42.1-99.6). For the presence of life-threatening abdominal pathology, the sensitivity was 100% (95% CI: 63.1-100). CONCLUSıON: It appears reasonable to utilize WBCT in patients where physicians expect life-threatening injury in any system. However, in cases where no pathology is expected in any system according to clinical prediction, we believe that performing WBCT solely based on trauma mechanism will not provide sufficient benefit.