Highlights from #EAST2014 - PTSD in Trauma Surgeons

While we're still trying to define the best way to identify and treat PTSD in our patients, this study shows that WE also suffer from PTSD.

UNVEILING POST-TRAUMATIC STRESS DISORDER IN TRAUMA SURGEONS: A NATIONAL SURVEY

Bellal Joseph, MD*, Viraj Pandit, MD, George Hadeed, MPH, Julie L. Wynne, MD, MPH*, Andrew L. Tang, MD*, Narong Kulvatunyou, MD*, Terence O'Keeffe, MD, MSPH*, Donald Green, MD, Randall S. Friese, MD*, Peter Rhee, MD, MPH*
The University of Arizona

Presenter: Bellal Joseph, MD
Discussant: Karen Lommel, DO, MHA, MS, University of Kentucky

Objectives: The significance of Post-Traumatic 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 screen and identify risk factors for the development of PTSD symptoms and diagnosis of PTSD among trauma surgeons.

Methods: We surveyed all members of the American Association for Surgery of Trauma (AAST) and the Eastern Association for Surgery of Trauma (EAST) using an established PTSD screening test (PTSD Checklist Specific- PCL- S). A PCL-S score of ≥35 (sensitivity ≥85%) was used as the cut off for development of PTSD symptoms and a PCL- S score ≥44 for the diagnosis of PTSD. Step wise forward multivariate logistic regression was used to determine independent risk factors for developing PTSD symptoms and diagnosis of PTSD.

Results: There were 453 respondents with a 41% response rate. The majority practiced in an urban (90%), Level I (71%), academic center (80%), with 24 hour resident coverage (83%). PTSD symptoms were present in 40% (n=181) of trauma surgeons and 15% (n=68) of trauma surgeons met the diagnostic criteria for PTSD. Salary, years of clinical practice, and previous military experience were neither predictive for the development of PTSD symptoms nor the diagnosis of PTSD.

Conclusions: Both symptoms and the diagnosis of Post-Traumatic Stress Disorder 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.