title: Unveiling posttraumatic stress disorder in trauma surgeons: a national survey.
abstract: BACKGROUND
  The significance of posttraumatic stress disorder (PTSD) in trauma patients is well recognized. The impact trauma surgeons endure in managing critical trauma cases is unknown. The aim of our study was to assess the incidence of PTSD among trauma surgeons and identify risk factors associated with the development of PTSD.
  
  
  METHODS
  We surveyed all members of the American Association for Surgery of Trauma and the Eastern Association for Surgery of Trauma using an established PTSD screening test (PTSD Checklist Civilian [PCL-C]). A PCL-C score of 35 or higher (sensitivity > 85%) was used as the cutoff for the development of PTSD symptoms and a PCL-C score of 44 or higher for the diagnosis of PTSD. Multivariate logistic regression was performed.
  
  
  RESULTS
  There were 453 respondents with a 41% response rate. PTSD symptoms were present in 40% (n = 181) of the trauma surgeons, and 15% (n = 68) of the trauma surgeons met the diagnostic criteria for PTSD. Male trauma surgeons (odds ratio [OR], 2; 95% confidence interval [CI], 1.2-3.1) operating more than 15 cases per month (OR, 3; 95% CI, 1.2-8), having more than seven call duties per month (OR, 2.6; 95% CI, 1.2-6), and with less than 4 hours of relaxation per day (OR, 7; 95% CI, 1.4-35) were more likely to develop symptoms of PTSD. Diagnosis of PTSD was common in trauma surgeons managing more than 5 critical cases per call duty (OR, 7; 95% CI, 1.1-8). Salary, years of clinical practice, and previous military experience were predictive for neither the development of PTSD symptoms nor the diagnosis of PTSD.
  
  
  CONCLUSIONS
  Both symptoms and the diagnosis of PTSD are common among trauma surgeons. Defining the factors that predispose trauma surgeons to PTSD may be of benefit to the patients and the profession. The data from this survey will be useful to major national trauma surgery associations for developing targeted interventions.
  
  
  METHODS
  Epidemiologic study, level III.
authors: From the Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
authors: Bellal
authors: B
authors: Joseph
authors: Viraj
authors: V
authors: Pandit
authors: George
authors: G
authors: Hadeed
authors: Narong
authors: N
authors: Kulvatunyou
authors: Bardiya
authors: B
authors: Zangbar
authors: Andrew
authors: A
authors: Tang
authors: Terence
authors: T
authors: O'Keeffe
authors: Julie
authors: J
authors: Wynne
authors: Donald J
authors: DJ
authors: Green
authors: Randall S
authors: RS
authors: Friese
authors: Peter
authors: P
authors: Rhee
mesh_terms: D000328:Adult; D057189:Checklist; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D010820:Physicians / Q000523:psychology*; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014194:Traumatology