TY - JOUR
T1 - Potential impact of propofol immediately after motor vehicle accident on later symptoms of posttraumatic stress disorder at 6-month follow up
T2 - a retrospective cohort study
AU - Usuki, Masato
AU - Matsuoka, Yutaka
AU - Nishi, Daisuke
AU - Yonemoto, Naohiro
AU - Matsumura, Kenta
AU - Otomo, Yasuhiro
AU - Kim, Yoshiharu
AU - Kanba, Shigenobu
N1 - Funding Information:
We thank Dr T Hifumi for useful advice on the drug assessment; Dr T Takagi for his valuable advice on anesthesiology; Mss Noguchi, Kawase, Sano, Hasegawa, and Takahashi for careful recruitment of and communication with the participants, and Mss. Akutsu, Kamoshida, and Suzuki for data management. The authors thank Ms T Usuki for her general support and warm encouragement. This study was supported by grants (16190501, 19230701 and 20300701) from the Japanese Ministry of Health, Labor, and Welfare (Research on Psychiatric and Neurological Disease and Mental Health) and CREST, the Japan Science and Technology Agency. The funding body did not play any role in the writing of the manuscript or in the decision to submit the manuscript for publication.
PY - 2012/10/28
Y1 - 2012/10/28
N2 - Introduction: Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a motor vehicle accident (MVA) affects the subsequent development of PTSD symptoms.Methods: We examined data obtained from a prospective cohort study of MVA-related injured patients, admitted to the intensive care unit of a general hospital. We investigated the effect of propofol administration within 72 h of MVA on outcome. Primary outcome was diagnosis of full or partial PTSD as determined by the Clinician-Administered PTSD Scale (CAPS) at 6 months. Secondary outcomes were diagnosis of full or partial PTSD at 1 month and CAPS score indicating PTSD at 1 and 6 months. Multivariate analysis was conducted adjusting for being female, age, injury severity score (ISS), and administration of ketamine or midazolam within 72 h of MVA.Results: Among 300 patients recruited (mean ISS, 8.0; median Glasgow Coma Scale (GCS) score, 15.0; age, 18 to 69 years), propofol administration showed a higher risk for full or partial PTSD as determined by CAPS at 6 months (odds ratio = 6.13, 95% confidence interval (CI): 1.57 to 23.85, P = 0.009) and at 1 month (odds ratio = 1.31, 95% CI: 0.41 to 4.23, P = 0.647) in the multivariate logistic regression. Multivariate regression analysis showed a trend toward adverse effects of propofol on PTSD symptom development at 6 months after MVA (β = 4.08, 95% CI: -0.49 to 8.64, P = 0.080), but not at 1 month after MVA (β = -0.42, 95% CI: -6.34 to 5.51, P = 0.890).Conclusions: These findings suggest that using propofol in the acute phase after MVA might be associated with the development of PTSD symptoms 6 months later. However, since the design of this study was retrospective, these findings should be interpreted cautiously and further study is warranted.
AB - Introduction: Critically injured patients are at risk of developing posttraumatic stress disorder (PTSD). Propofol was recently reported to enhance fear memory consolidation retrospectively. Thus, we investigated here whether administration of propofol within 72 h of a motor vehicle accident (MVA) affects the subsequent development of PTSD symptoms.Methods: We examined data obtained from a prospective cohort study of MVA-related injured patients, admitted to the intensive care unit of a general hospital. We investigated the effect of propofol administration within 72 h of MVA on outcome. Primary outcome was diagnosis of full or partial PTSD as determined by the Clinician-Administered PTSD Scale (CAPS) at 6 months. Secondary outcomes were diagnosis of full or partial PTSD at 1 month and CAPS score indicating PTSD at 1 and 6 months. Multivariate analysis was conducted adjusting for being female, age, injury severity score (ISS), and administration of ketamine or midazolam within 72 h of MVA.Results: Among 300 patients recruited (mean ISS, 8.0; median Glasgow Coma Scale (GCS) score, 15.0; age, 18 to 69 years), propofol administration showed a higher risk for full or partial PTSD as determined by CAPS at 6 months (odds ratio = 6.13, 95% confidence interval (CI): 1.57 to 23.85, P = 0.009) and at 1 month (odds ratio = 1.31, 95% CI: 0.41 to 4.23, P = 0.647) in the multivariate logistic regression. Multivariate regression analysis showed a trend toward adverse effects of propofol on PTSD symptom development at 6 months after MVA (β = 4.08, 95% CI: -0.49 to 8.64, P = 0.080), but not at 1 month after MVA (β = -0.42, 95% CI: -6.34 to 5.51, P = 0.890).Conclusions: These findings suggest that using propofol in the acute phase after MVA might be associated with the development of PTSD symptoms 6 months later. However, since the design of this study was retrospective, these findings should be interpreted cautiously and further study is warranted.
UR - http://www.scopus.com/inward/record.url?scp=84867457940&partnerID=8YFLogxK
U2 - 10.1186/cc11681
DO - 10.1186/cc11681
M3 - 学術論文
C2 - 23075426
AN - SCOPUS:84867457940
SN - 1364-8535
VL - 16
JO - Critical Care
JF - Critical Care
IS - 5
M1 - R196
ER -