Post-Traumatic Stress Disorder Symptomology Associated with Witnessing Unsuccessful Out-of-hospital Cardiopulmonary Resuscitation
Post-Traumatic Stress Disorder Symptomology Associated with Witnessing Unsuccessful Out-of-hospital Cardiopulmonary Resuscitation
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DOI：
10.1111/j.1553-2712.2008.00336.x
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发表时间：
2009-03-01
影响因子：
4.4
通讯作者：
Swor, Robert A.
中科院分区：
文献类型：
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作者：
Compton, Scott;Grace, Heather;Swor, Robert A.
目的是评估与亲眼目睹家庭成员院外心肺复苏 (CPR) 失败相关的创伤后应激障碍 (PTSD) 症状。事件发生后 1 个月开始，我们通过电话联系被送往一家大型中西部医院的已故成人非院外心脏骤停受害者的成年家庭成员。受试者根据患者复苏期间是否在场而被分为两类。结构化访谈获得了患者的逮捕前功能、家庭成员是否见证或进行了心肺复苏、患者和家庭人口统计数据、关键的心脏骤停事件以及受试者 PTSD 症状的测量（PTSD 症状量表访谈 [PSS-I]）。共有 34 名目击者和 20 名非目击者。每组的种族、宗教、年龄、性别以及与患者的关系都相似。每组患者的逮捕前功能相似。目击者的 PTSD 症状总分几乎是非目击者的两倍（分别为 14.47 比 7.60；平均差 = 6.87，95% 置信区间 [CI] = 0.57 至 13.17）。目击者的两个 PSS-I 分量表高于非目击者：回避（5.41 vs. 2.25；平均差异 = 3.16，95% CI = 0.74 至 5.58）和增加唤醒（4.26 vs. 2.20；平均差异 = 2.06，95% CI = 0.08 至 4.05），而重新体验则不然（4.79 与 3.15；平均差 = 1.64，95% CI = -0.62 至 3.91）。线性回归分析表明，在控制其他潜在影响事件和特征的可能性后，见证亲人的心肺复苏与 PSS-I 平均增加近 12 点相关。当 CPR 提供者 (n = 6) 从目击者组中移除时，结果相似。在医院外目睹亲人的 CPR 尝试失败可能与在丧亲之痛的早期表现出 PTSD 症状有关。虽然是初步的，但这些数据表明，即使在控制了也可能影响出现此类症状的倾向的其他潜在因素（例如患者心脏骤停的突然性和位置）之后，这种关系仍然存在。
The objective was to assess symptoms of post-traumatic stress disorder (PTSD) associated with witnessing unsuccessful out-of-hospital cardiopulmonary resuscitation (CPR) on a family member.Adult family members of deceased, adult, nontraumatic out-of-hospital cardiac arrest victims who were transported to a large, Midwestern hospital were contacted by telephone beginning 1 month after the event. Subjects were dichotomized as to whether or not they were physically present during the patient's resuscitation. A structured interview obtained the patient's prearrest functioning, whether the family member witnessed or performed CPR, patient and family demographic data, key cardiac arrest events, and a measure of subject PTSD symptoms (PTSD Symptom Scale-Interview [PSS-I]).There were 34 witnesses and 20 nonwitnesses. Each group was similar in race, religion, age, gender, and relationship to the patient. Patients in each group were similar in prearrest functioning. Witnesses' total PTSD symptom scores were nearly two times higher than nonwitnesses (14.47 vs. 7.60, respectively; mean difference = 6.87, 95% confidence interval [CI] = 0.57 to 13.17). Two PSS-I subscales were higher for witnesses than nonwitnesses: Avoidance (5.41 vs. 2.25; mean difference = 3.16, 95% CI = 0.74 to 5.58) and Increased Arousal (4.26 vs. 2.20; mean difference = 2.06, 95% CI = 0.08 to 4.05), while Reexperiencing was not (4.79 vs. 3.15; mean difference = 1.64, 95% CI = -0.62 to 3.91). Linear regression analysis indicated that witnessing CPR of a loved one was associated with a mean increase of nearly 12 points on the PSS-I after controlling for the possibility of other potentially influential events and characteristics. Results were similar when CPR providers (n = 6) were removed from the witness group.Witnessing a failed CPR attempt of a loved one in an out-of-hospital location may be associated with displaying symptoms of PTSD in the early term of the bereavement period. While preliminary, these data suggest that the relationship exists even after controlling for other potential factors that may also affect the propensity for displaying such symptoms, such as the suddenness and location of the patient's cardiac arrest.