Elevated heart rate at emergency department triage increased the likelihood of partial or full PTSD at 6 months in children with traffic-related injuries (adjusted OR 2.4; 95% CI 1.1-5.4).
Cohort (n=190)
No
Does elevated heart rate at ED triage predict the development of PTSD in traumatically injured children?
Elevated heart rate at emergency department triage is associated with an increased risk of developing PTSD in traumatically injured children.
Odds Ratio: 2.4 (95% CI 1.1–5.4)
BACKGROUND: Elevated, acute heart rate has been related to later posttraumatic stress disorder (PTSD) development in injured adults, but this has not been examined in children and adolescents. Better understanding of the relationship between acute physiological arousal and later child PTSD could help elucidate the etiology of posttrauma responses in children and might identify useful markers for PTSD risk. OBJECTIVE: To evaluate the relationship between heart rate assessed in the emergency department (ED) during normal clinical care and later PTSD outcome in traumatically injured children. DESIGN: Prospective cohort study assessed heart rate at ED triage and PTSD an average of 6 months' postinjury. SETTING: Large, urban pediatric academic medical center in the northeastern United States. PARTICIPANTS: One hundred ninety children and adolescents (aged 8-17 years) hospitalized for traffic-related injury.Main Outcome Measure Clinician-Administered PTSD Scale for Children and Adolescents. RESULTS: The group of children who developed partial or full PTSD had a higher mean +/- SD heart rate at ED triage than those who did not go on to have PTSD (109.6 +/- 22.3 vs 99.7 +/- 18.0 beats per minute). Children with an elevated heart rate (defined as >/=2 SDs higher than the normal resting heart rate for their age and sex) at ED triage were more likely to meet criteria for partial or full PTSD at follow-up, even after adjusting for age, sex, and injury (adjusted odds ratio, 2.4 95% confidence interval, 1.1-5.4). CONCLUSION: These results suggest an association between early physiological arousal and the development or persistence of PTSD symptoms in injured children and point to the importance of better understanding the interplay between physiological and psychological functioning after a traumatic stressor.
Kassam‐Adams et al. (2005) conducted a cohort in Traffic-related injury (n=190). Elevated heart rate at ED triage vs. Normal heart rate was evaluated on Partial or full PTSD (Clinician-Administered PTSD Scale for Children and Adolescents) (OR 2.4, 95% CI 1.1-5.4). Elevated heart rate at emergency department triage increased the likelihood of partial or full PTSD at 6 months in children with traffic-related injuries (adjusted OR 2.4; 95% CI 1.1-5.4).
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