BACKGROUND: Psychological consequences such as post-traumatic stress disorder (PTSD) are currently neglected in burden-of-injury calculations. AIM: To assess the disease burden of PTSD due to unintentional injury and compare this health loss with physical injury consequences. METHODS: From literature sources, the prevalence of PTSD at four follow-up periods (<3 months, 3-6 months, 7-12 months and >12 months) was estimated. The uncertainty of the estimated PTSD prevalence was modelled by a Bayesian approach. The prevalence rates were then linked to national data on unintentional injury, disability weights and duration to estimate the incidence and disability-adjusted life years (DALY) resulting from PTSD in addition to physical injury consequences. RESULTS: The data suggest that PTSD prevalence among injury victims decreases over time. The average PTSD prevalence at <3 months follow-up was 21% (90% credibility interval (CI) 17% to 24%) for patients presenting at the emergency department and 30% (90% CI 27% to 33%) for patients who were hospitalised, tapering down after 12 months to 4% (90% CI 3% to 5%) and 6% (90% CI 4% to 10%), respectively. These estimates translate into 191,000 (90% CI 161,000 to 222,000) cases of PTSD per year in the Dutch population (1.2%) due to unintentional injury. Including PTSD increases the non-fatal burden of disease of unintentional injuries by 53% (from 116,000 to 178,000 DALYs (90% CI 150,000 to 217,000)). CONCLUSIONS: Ignoring PTSD in burden-of-injury studies results in a considerable underestimation of the burden of injury. This may affect resource allocation and the identification of important prevention priorities.
BACKGROUND: Psychological consequences such as post-traumatic stress disorder (PTSD) are currently neglected in burden-of-injury calculations. AIM: To assess the disease burden of PTSD due to unintentional injury and compare this health loss with physical injury consequences. METHODS: From literature sources, the prevalence of PTSD at four follow-up periods (<3 months, 3-6 months, 7-12 months and >12 months) was estimated. The uncertainty of the estimated PTSD prevalence was modelled by a Bayesian approach. The prevalence rates were then linked to national data on unintentional injury, disability weights and duration to estimate the incidence and disability-adjusted life years (DALY) resulting from PTSD in addition to physical injury consequences. RESULTS: The data suggest that PTSD prevalence among injury victims decreases over time. The average PTSD prevalence at <3 months follow-up was 21% (90% credibility interval (CI) 17% to 24%) for patients presenting at the emergency department and 30% (90% CI 27% to 33%) for patients who were hospitalised, tapering down after 12 months to 4% (90% CI 3% to 5%) and 6% (90% CI 4% to 10%), respectively. These estimates translate into 191,000 (90% CI 161,000 to 222,000) cases of PTSD per year in the Dutch population (1.2%) due to unintentional injury. Including PTSD increases the non-fatal burden of disease of unintentional injuries by 53% (from 116,000 to 178,000 DALYs (90% CI 150,000 to 217,000)). CONCLUSIONS: Ignoring PTSD in burden-of-injury studies results in a considerable underestimation of the burden of injury. This may affect resource allocation and the identification of important prevention priorities.
Authors: C C H M van Delft-Schreurs; J J M van Bergen; P van de Sande; M H J Verhofstad; J de Vries; M A C de Jongh Journal: Qual Life Res Date: 2013-11-08 Impact factor: 4.147
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