Injury-specific predictors of posttraumatic stress disorder.
OBJECTIVE
Posttraumatic stress disorder (PTSD) is an important source of morbidity in military personnel, but its relationship with characteristics of battle injury has not been well defined. The aim of this study was to characterise the relationship between injury-related factors and PTSD among a population of battle injuries.


METHODS
A total of 831 American military personnel injured during combat between September 2004 and February 2005 composed the study population. Patients were followed through November 2006 for diagnosis of PTSD (ICD-9 309.81) or any mental health outcome (ICD-9 290-319).


RESULTS
During the follow-up period, 31.3% of patients received any type of mental health diagnosis and 17.0% received a PTSD diagnosis. Compared with minor injuries those with moderate (odds ratio [OR], 2.37; 95% confidence interval [CI], 1.61-3.48), serious (OR, 4.07; 95% CI, 2.55-6.50), and severe (OR, 5.22; 95% CI, 2.74-9.96) injuries were at greater risk of being diagnosed with any mental health outcome. Similar results were found for serious (OR, 3.03; 95% CI, 1.81-5.08) and severe (OR, 3.21; 95% CI, 1.62-6.33) injuries with PTSD diagnosis. Those with gunshot wounds were at greater risk of any mental health diagnosis, but not PTSD, in comparison with other mechanisms of injury (OR 2.07; 95% CI, 1.35, 3.19). Diastolic blood pressure measured postinjury was associated with any mental health outcome, and the effect was modified by injury severity.


CONCLUSIONS
Injury severity was a significant predictor of any mental health diagnosis and PTSD diagnosis. Gunshot wounds and diastolic blood pressure were significant predictors of any mental health diagnosis, but not PTSD. Further studies are needed to replicate these results and elucidate potential mechanisms for these associations.
MacGregor
Andrew J
AJ
Department of Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, CA 92106, USA.
Corson
Karen S
KS
Larson
Gerald E
GE
Shaffer
Richard A
RA
Dougherty
Amber L
AL
Galarneau
Michael R
MR
Raman
Rema
R
Baker
Dewleen G
DG
Lindsay
Suzanne P
SP
Golomb
Beatrice A
BA
D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000523:psychology; D003130:Combat Disorders / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D009326:Naval Medicine; D012044:Regression Analysis; D014481:United States; D014947:Wounds and Injuries / Q000523:psychology*; D055815:Young Adult