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Heart rate measured in the acute aftermath of trauma can predict post-traumatic stress disorder: A prospective study in motor vehicle accident survivors

Published online by Cambridge University Press:  16 April 2020

R. Coronas ,
O. Gallardo ,
M.J. Moreno ,
D. Suárez ,
G. García-Parés  and
J.M. Menchón
R. Coronas*
Affiliation:
Corporació Sanitària Parc Taulí, Institut Universitari Fundació Parc Taulí-Universitat Autònoma de Barcelona (IUFPT-UAB), Sabadell, Spain
O. Gallardo
Affiliation:
Parc Taulí Accidents de Trànsit (Trafisaba), Sabadell, Spain
M.J. Moreno
Affiliation:
Corporació Sanitària Parc Taulí, Institut Universitari Fundació Parc Taulí-Universitat Autònoma de Barcelona (IUFPT-UAB), Sabadell, Spain
D. Suárez
Affiliation:
Epidemiology and Assessment Unit, Institut Universitari Fundació Parc Taulí-Universitat Autònoma de Barcelona (IUFPT-UAB), Sabadell, Spain
G. García-Parés
Affiliation:
Corporació Sanitària Parc Taulí, Institut Universitari Fundació Parc Taulí-Universitat Autònoma de Barcelona (IUFPT-UAB), Sabadell, Spain
J.M. Menchón
Affiliation:
Department of Psychiatry, University of Barcelona, Hospital de Bellvitge, L’Hospitalet de Llobregat, Spain
*
*Corresponding author. Psychiatry Department, Hospital de Sabadell, Parc Taulĩ 1, 08208 Sabadell, Barcelona, Spain. Tel.: +34 937231010/22171; fax: +34 937237181. E-mail address: rcoronas@tauli.cat (R. Coronas).
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Abstract

Objective

To determine whether increased physiological arousal immediately after trauma or at emergency admission can predict post-traumatic stress disorder (PTSD) in motor vehicle accident (MVA) survivors with physical injuries.

Methods

We included 119 MVA survivors with physical injuries. In this prospective cohort study, heart rate (HR) and blood pressure (BP) were assessed during ambulance transport (T1) and at hospital admission (T2). One and four months after the accident, we assessed patients for PTSD (Davidson trauma scale, confirmed with the structured clinical interview for DSM-IV axis I disorders). Multivariate logistic regression models assessed the relationship between HR or BP and PTSD.

Results

PTSD was diagnosed in 54 (45.4%) patients at 1 month and in 39 (32.8%) at 4 months. In the multivariate analysis, HR at T1 or at T2 predicted PTSD at 1 month (OR=1.156, 95% CI [1.094;1.221] p < 0.0001). Only HR at T1 (not at T2) predicted PTSD at 4 months (OR=1.059, 95% CI [1.013; 1.108] p = 0.012). Injury severity predicted PTSD at 4 months (OR=1.207, 95% CI [1.085; 1.342] p = 0.001). A cut-off of 84 beats per minute yielded a sensitivity of 62.5% and a specificity of 75.0% for PTSD.

Conclusions

HR measured at the scene of MVA and severity of injury predicted PTSD 4 months later.

Keywords

PTSDMotor vehicle accidentsHeart rateBlood pressure
Type
Original article
Information
European Psychiatry , Volume 26 , Issue 8 , November 2011 , pp. 508 - 512
Copyright
Copyright © Elsevier Masson SAS 2011

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Footnotes

Abbreviations, MVA motor vehicle accidents, PTSD post-traumatic stress disorder, DSM-IV-TR diagnostic and statistical manual of mental disorders, 4th edition, SCID Istructured clinical interview for DSM-IV, DTS Davidson trauma scale, ISS injury severity score, GCS Glasgow coma scale, MMSE mini mental state examination, MINI mini-international neuropsychiatric interview

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