The predictive effect of ASD on PTSD and the factors influencing ASD and PTSD

To investigate the prevalence and influencing factors of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) in trauma patients, and to explore the predictive effect of ASD on PTSD.

A prospective study was conducted on patients hospitalized due to injuries. The first survey used the ASD scale to assess the occurrence of ASD. In one month and three months of follow-up after injury, patients were assessed for the occurrence of PTSD by using the PTSD checklist-civilian version.

The prevalence rates of ASD, one-month PTSD, and three-month PTSD in trauma inpatients were 20.7%, 19.5%, and 17.6%, respectively. ASD is a strong predictor of PTSD, and combining it with severe injury and critical illness can improve the sensitivity and positive predictive ability of predicting the occurrence of PTSD (AUC_Max: 0.827). The important predictive factor for the diagnosis of PTSD is the high alert symptom group of ASD. Moreover, the analysis results showed that the season of trauma happened, comatose state, fear state, psychological burden, and pain intensity were the influencing factors for ASD (P<0.05), while critical illness during hospitalization, psychological burden, and pain intensity were the influencing factors for PTSD (P<0.05).

Some patients with minor and extremely serious injuries were overlooked or missed, resulting in selection bias and information bias that could not be completely avoided.

Both trauma conditions and clinical features may affect the occurrence of ASD and PTSD in trauma patients. If ASD in trauma patients is identified early and targeted interventions, it may reduce the occurrence and development of PTSD.