Posttraumatic stress disorder in patients who rule out versus rule in for acute coronary syndrome

General Hospital Psychiatry
Ian M KronishWilliam Whang

Abstract

Many patients who present to the emergency department (ED) with acute coronary syndromes (ACS) develop posttraumatic stress disorder (PTSD) due to the experience. Less is known about risk for PTSD in patients who rule out for ACS. Our objective was to compare the risk of developing PTSD among patients who rule out versus rule in for ACS. We enrolled a consecutive sample of 1000 patients presenting to an emergency department (ED) with symptoms of a probable ACS. We assessed presenting ACS symptoms in the ED. We determined whether presenting symptoms were due to a confirmed ACS or another etiology by chart review. We assessed PTSD by telephone 1 month after discharge using the PTSD Checklist specific for the suspected ACS event (PCL-S). We used logistic regression to determine the association of ruling out versus ruling in for ACS with a positive PTSD screen (PCL-S ≥ 32), adjusting for demographics, comorbidities, depression, trauma history, and pre-existing PTSD. Approximately two-thirds of patients (68.2%) ruled out for ACS. Compared to confirmed ACS patients, patients who ruled out had similar presenting symptoms, and similar risk of screening positive for PTSD (18.9% versus 16.8%; p = 0.47; adjusted OR 1.18, 95% CI 0.69-2.00;...Continue Reading

Citations

Jul 5, 2018·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Talea CorneliusBernard P Chang
Oct 28, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Jeena MossBrian W Roberts
Oct 3, 2020·Journal of Traumatic Stress·Murielle Jacquet-SmailovicMarie-Jo Brennstuhl
Nov 2, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Paul I MuseyBernard P Chang
Mar 31, 2021·Journal of General Internal Medicine·Lorenzo TarsitaniGabriella d'Ettorre

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