Background: The purpose of this study was to determine the
prevalence of posttraumatic stress disorder among patients seen following an
orthopaedic traumatic injury and to identify whether injury-related or
demographic variables are associated with the disorder.
Methods: Five hundred and eighty patients who had sustained
orthopaedic trauma completed a Revised Civilian Mississippi Scale for
Posttraumatic Stress Disorder questionnaire. Demographic and injury data were
collected to analyze potential variables associated with posttraumatic stress
Results: Two hundred and ninety-five respondents (51%) met the
criteria for the diagnosis of posttraumatic stress disorder. Patients with
posttraumatic stress disorder had significantly higher Injury Severity Scores
(p = 0.04), a higher sum of Extremity Abbreviated Injury Scores (p = 0.05),
and a longer duration since the injury than those without posttraumatic stress
disorder (p < 0.01). However, none of these three variables demonstrated a
good or excellent ability to discriminate between patients who had
posttraumatic stress disorder and those who did not. The response to the item,
"The emotional problems caused by the injury have been more difficult
than the physical problems," was significantly associated with the
presence of posttraumatic stress disorder (p < 0.0001) and showed a fair
ability to identify patients with the disorder.
Conclusions: Posttraumatic stress disorder is common after
orthopaedic trauma. Patients who respond positively to the item, "The
emotional problems caused by the injury have been more difficult than the
physical problems," may meet diagnostic criteria for this disorder and
should be evaluated further.
Level of Evidence: Prognostic study, Level I-1
(prospective study). See Instructions to Authors for a complete description of
levels of evidence.