ICU多发伤青少年病人创伤后应激障碍的潜在剖面分析及影响因素OA北大核心

Objective:To explore the current status of post-traumatic stress disorder(PTSD)in adolescent patients with multiple injuries in the ICU and to analyse the differences in the potential characteristics of PTSD in different categories of adolescent patients.Methods:304 adolescent patients with multiple injuries in the comprehensive ICU of a tertiary hospital in Zhengzhou from January 2022 to September 2023 were selected.Patients were assessed using the Posttraumatic Stress Disorder Inventory-Civilian version(PCL-C)at 1 month of transfer out of the ICU.The potential profile of PTSD symptoms in adolescent patients with multiple injuries in ICU was analyzed,and the influencing factors were identified by disordered multiple classification Logistic regression.Results:The incidence of PTSD in adolescent patients with multiple injuries in the ICU was 51.6%,with a PCL-C score of 48.26±4.73.PTSD symptom profiles were divided into 3 potential profile categories,which were"a low stress group"(31.2% ),"a high symptom group"(38.9% ),and"an alert stress group"(29.9% ).The probability of being attributed to the stress low group was higher in the symptomatic high group compared to the stress low group in patients who were not mechanically ventilated(OR=0.040,P=0.032)and who were not sedated(OR=0.049,P=0.043)and the probability of being attributed to the stress low group was higher in patients who had a higher ISS score(OR=1.220,P=0.040)and a higher APACHE Ⅱ score(OR=1.997,P=0.001)were higher,the higher the probability of belonging to the symptomatic high incidence group.Male patients(OR=0.020,P<0.001)had a higher probability of belonging to the stress low group compared to the alert stress group,and higher APACHE Ⅱ scores(OR=1.622,P=0.007)were associated with a higher probability of belonging to the alert stress group.Conclusion:There is heterogeneity in PTSD symptoms in adolescent patients with multiple injuries.Sex,mechanical ventilation,use of sedative drugs or not,ISS scores and APACHE Ⅱ scores were influencing factors of different categories.Clinical staff should pay attention to the heterogeneity of PTSD symptom profiles in adolescent patients with multiple injuries in the ICU and give targeted interventions to different categories of patients.