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Utility of the injured trauma survivor screen to predict PTSD and depression during hospital admission

Hunt, Joshua C. PhD; Sapp, Marty EdD; Walker, Cindy PhD; Warren, Ann Marie PhD; Brasel, Karen MD, MPH; deRoon-Cassini, Terri A. PhD

Journal of Trauma and Acute Care Surgery: January 2017 - Volume 82 - Issue 1 - p 93–101
doi: 10.1097/TA.0000000000001306
AAST Plenary Papers

BACKGROUND The brief, easily administered screen, the Injured Trauma Survivor Screen (ITSS), was created to identify trauma survivors at risk for development of posttraumatic stress disorder (PTSD) and depression.

METHODS An item pool of PTSD risk factors was created and given, along with a previously created screen, to patients admitted to two Level 1 trauma centers. The Clinician Administered PTSD Scale for DSM-5, the PTSD Checklist for DSM-5, and the Center for Epidemiological Studies Depression Scale Revised were given during a 1-month follow-up. A total of 139 participants were included (n = 139; μ age = 41.06; 30.9% female; 47.5% White/Caucasian; 39.6% Black/African American; 10.1% Latino/Hispanic; 1.4% American Indian; and 1.4% other). Stepwise bivariate logistic regression was used to determine items most strongly associated with PTSD and depression diagnosis 1 month after injury.

RESULTS Forty participants met criteria for a PTSD diagnosis and 28 for depression at follow-up (22 comorbid). ROC curve analysis was used to determine sensitivity (PTSD = 75.00, Depression = 75.00), specificity (PTSD = 93.94, Depression = 95.5), NPV (PTSD = 90.3, Depression = 80.8), and PPV (PTSD = 83.3, Depression = 93.8) of the final nine-item measure.

CONCLUSIONS This study provides evidence for the utility of a predictive screen, the ITSS, to predict which injured trauma survivors admitted to the hospital are at the most risk for developing symptoms of PTSD and depression 1 month after injury. The ITSS is a short, easily administered tool that can aid in reducing the untreated cases of PTSD and depression.

LEVEL OF EVIDENCE Prognostic study, level III.

Supplemental digital content is available in the text.

From the University of Wisconsin–Milwaukee (M.S., C.W.), Milwaukee, Wisconsin; Baylor University Medical Center (A.M.W.), Dallas, Texas; Oregon Health and Science University (K.B.), Portland, Oregon; and Medical College of Wisconsin (J.C.H., T.A.d-C.), Milwaukee, Wisconsin.

Submitted: July 6, 2016, Revised: September 28, 2016, Accepted: October 4, 2016, Published online: October 25, 2016.

This study was presented at 75th annual meeting of the American Association for the Surgery of Trauma, September 14–17, 2016, in Waikoloa, Hawaii.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (

Address for reprints: Joshua C. Hunt, PhD, Medical College of Wisconsin, 9200 West Wisconsin Ave., Milwaukee, WI 53226; email:

© 2017 Lippincott Williams & Wilkins, Inc.