دورية أكاديمية
Glasgow Coma Scores, early opioids, and posttraumatic stress disorder among combat amputees.
| العنوان: | Glasgow Coma Scores, early opioids, and posttraumatic stress disorder among combat amputees. |
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| المؤلفون: | Melcer T; Department of Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, California, USA., Walker J, Sechriest VF 2nd, Lebedda M, Quinn K, Galarneau M |
| المصدر: | Journal of traumatic stress [J Trauma Stress] 2014 Apr; Vol. 27 (2), pp. 152-9. Date of Electronic Publication: 2014 Mar 25. |
| نوع المنشور: | Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley Country of Publication: United States NLM ID: 8809259 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-6598 (Electronic) Linking ISSN: 08949867 NLM ISO Abbreviation: J Trauma Stress Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : Hoboken, NJ : Wiley Original Publication: New York ; London : Plenum Press, c1988- |
| مواضيع طبية MeSH: | Glasgow Coma Scale*, Amnesia/*chemically induced , Amputees/*psychology , Analgesics, Opioid/*therapeutic use , Fentanyl/*therapeutic use , Memory/*drug effects , Morphine/*therapeutic use , Stress Disorders, Post-Traumatic/*prevention & control, Afghan Campaign 2001- ; Amputees/statistics & numerical data ; Analgesics, Opioid/pharmacology ; Comorbidity ; Drug Therapy, Combination ; Fentanyl/pharmacology ; Humans ; Iraq War, 2003-2011 ; Morphine/pharmacology ; Pain/drug therapy ; Pain/etiology ; Prevalence ; Protective Factors ; Registries ; Retrospective Studies ; Stress Disorders, Post-Traumatic/epidemiology ; Stress Disorders, Post-Traumatic/psychology ; Unconsciousness/physiopathology ; Unconsciousness/psychology ; Young Adult |
| مستخلص: | A recent study found that combat amputees had a reduced prevalence of posttraumatic stress disorder (PTSD) compared with nonamputees with serious extremity injuries. We hypothesized that an extended period of impaired consciousness or early treatment with morphine could prevent consolidation of traumatic memory and the development of PTSD. To examine this hypothesis, we retrospectively reviewed 258 combat casualty records from the Iraq or Afghanistan conflicts from 2001-2008 in the Expeditionary Medical Encounter Database, including medications and Glasgow Coma Scale (GCS) scores recorded at in-theater facilities within hours of the index injury. All patients sustained amputations from injuries. Psychological diagnoses were extracted from medical records for 24 months postinjury. None of 20 patients (0%) with GCS scores of 12 or lower had PTSD compared to 20% of patients with GCS scores of 12 or greater who did have PTSD. For patients with traumatic brain injury, those treated with intravenous morphine within hours of injury had a significantly lower prevalence of PTSD (6.3%) and mood disorders (15.6%) compared to patients treated with fentanyl only (prevalence of PTSD = 41.2%, prevalence of mood disorder = 47.1%). GCS scores and morphine and fentanyl treatments were not significantly associated with adjustment, anxiety, or substance abuse disorders. (Published 2014. This article is a US Government work and is in the public domain in the USA.) |
| المشرفين على المادة: | 0 (Analgesics, Opioid) 76I7G6D29C (Morphine) UF599785JZ (Fentanyl) |
| تواريخ الأحداث: | Date Created: 20140327 Date Completed: 20141212 Latest Revision: 20140417 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1002/jts.21909 |
| PMID: | 24668780 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1573-6598 |
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| DOI: | 10.1002/jts.21909 |