Predictors of Post-Traumatic Stress Symptoms after musculoskeletal trauma

by Ferozkhan Jadhakhan, Deborah Falla, Alexander Dallaway Background Post-traumatic stress symptoms (PTSS) are common following musculoskeletal trauma and are associated with poorer recovery, disability, and reduced quality of life. Although psychosocial and injury-related factors have been linked to PTSS, limited research has examined longitudinal predictors or the relationship between injury severity and PTSS progression in people hospitalised for musculoskeletal trauma.

Objectives To identify predictors of PTSS at three and six months following musculoskeletal trauma and hospitalisation, and to examine the relationship between injury severity and PTSS severity over time. Methods This secondary analysis of a prospective cohort study included 125 adults admitted to a UK major trauma centre with acute musculoskeletal injuries.

PTSS were assessed using the Impact of Event Scale–Revised (IES-R) at baseline, three, and six months, with scores ≥22 indicating elevated PTSS. Candidate predictors included socio-demographic, clinical, and trauma-related variables.

Multivariate logistic regression identified predictors at three and six months. Multicollinearity was assessed using variance inflation factors and principal component analysis.

Injury severity (mild, moderate, major) was examined using Kruskal-Wallis and Mann-Whitney U tests.