Key result
Persistent posttraumatic stress affects ~17% of type A aortic dissection survivors, driven by perceived illness threat.
Why the study?
Longitudinal trajectories of post-traumatic stress symptoms (PTSS) after acute type A aortic dissection (ATAAD) and the baseline and time-varying psychological factors associated with subsequent symptom burden needed to be identified in a nurse-led follow-up cohort.
What are the 12-month longitudinal trajectories of post-traumatic stress symptoms and their associated baseline and time-varying psychological factors in adult survivors of acute type A aortic dissection undergoing nurse-led follow-up?
Cohort (n=278)
No
What are the 12-month longitudinal trajectories of post-traumatic stress symptoms and their associated baseline and time-varying psychological factors in adult survivors of acute type A aortic dissection undergoing nurse-led follow-up?
Approximately one in six acute type A aortic dissection survivors experiences a persistent-high trajectory of post-traumatic stress symptoms over 12 months, which is dynamically predicted by within-person increases in illness threat, insomnia, and repetitive negative thinking, as well as lower social support.
17% of acute type A aortic dissection survivors follow persistent-high PTSS trajectories; leaves open whether targeting illness threat or social support improves outcomes.
Objective: To identify longitudinal trajectories of post-traumatic stress symptoms (PTSS) after acute type A aortic dissection (ATAAD) and to examine baseline and time-varying psychological factors associated with subsequent symptom burden in a nurse-led follow-up cohort. Methods: This single-center retrospective longitudinal cohort study included 278 ATAAD survivors discharged from Henan Provincial Chest Hospital between 1 August 2023 and 30 July 2024. Clinical and nurse-led follow-up records through 1 August 2025 were reviewed for assessments at discharge and at 1, 3, 6, and 12 months. The primary trajectory analysis used PCL-5 scores from 1 to 12 months among participants with at least two valid assessments. One- through four-class latent class mixed models were compared according to convergence, Bayesian information criterion, classification quality, and minimum class size. Baseline correlates were examined with multinomial regression. Lagged models separated between-person means from within-person changes in illness threat, insomnia, and repetitive negative thinking; social support was examined across the 3-to-6-month interval. Results: A three-class solution was selected: low-decreasing (n=153, 55.0%), recovering (n=77, 27.7%), and persistent-high (n=48, 17.3%). Within-person increases in illness threat, insomnia, and repetitive negative thinking were associated with higher subsequent PCL-5 scores, whereas higher social support was associated with a lower subsequent score. Baseline associations were attenuated after multiplicity correction. Conclusion: The model identified three PTSS trajectories during the first year after ATAAD discharge. Repeated nurse-led assessment may help identify survivors with a persistent symptom burden, and changes in illness threat, insomnia, repetitive negative thinking, and social support may inform the timing and focus of transitional care. The effectiveness of screening or targeted care was not tested.
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Tang et al. (2026) conducted a cohort in Acute Stanford type A aortic dissection (ATAAD) (n=278). Longitudinal psychological processes (illness-threat perceptions, insomnia, repetitive negative thinking, social support) and baseline clinical factors vs. Persistent-high trajectory class (for baseline correlates) or within/between-person reference levels was evaluated on Total score on the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) from 1 to 12 months (within-person lagged effect of illness-threat perceptions per 1-SD increase) (MD 2.92, 95% CI 2.33 to 3.50, p=<0.001). Acute type A aortic dissection survivors exhibited three 1-year PTSS trajectories: low-decreasing (55.0%), recovering (27.7%), and persistent-high (17.3%), driven by illness threat (MD 2.92, P<0.001).
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