Symptom cluster profiles following traumatic orthopaedic injuries

Area of Science:

• Orthopaedic Surgery
• Psychiatry
• Genetics

Background:

• Millions of Americans sustain traumatic orthopaedic injuries (TOIs) annually.
• Common post-injury symptoms include acute stress disorder (ASD), anxiety, depression, pain, and sleep disturbance, often occurring in clusters.
• Symptom cluster profiles characterize TOI survivors' experiences, with brain-derived neurotrophic factor (BDNF) potentially underlying these profiles.

Purpose of the Study:

• To identify distinct symptom cluster profiles in traumatic orthopaedic injury survivors.
• To investigate the association of sociodemographic, clinical, and biological factors with these symptom cluster profiles.

Main Methods:

• Hospitalized TOI survivors were recruited within 72 hours of injury.
• Symptoms were assessed using the Acute Stress Disorder Scale and PROMIS short forms.
• Serum BDNF concentrations and rs6265 genotypes were measured; latent profile analysis identified symptom clusters.

Main Results:

• Four symptom cluster profiles were identified: Physical Symptoms Only, Mild, Moderate, and Severe Psychological Distress.
• Lower odds of psychological distress clusters were associated with older age, Black race, resilience, and higher serum BDNF.
• Higher odds of psychological distress clusters were associated with female sex; clinical characteristics and rs6265 genotypes showed no association.

Conclusions:

• TOI survivors exhibit distinct symptom cluster profiles.
• Sociodemographic characteristics and serum BDNF concentrations, rather than clinical factors, are associated with symptom cluster membership.
• Findings support comprehensive symptom screening and treatment for TOI survivors, and further evaluation of BDNF as a biomarker for post-injury symptom burden.