Accession Number:

ADA618678

Title:

Glasgow Coma Scale Scores, Early Opioids, and 4-year Psychological Outcomes among Combat Amputees

Descriptive Note:

Journal article

Corporate Author:

NAVAL HEALTH RESEARCH CENTER SAN DIEGO CA

Report Date:

2014-01-01

Pagination or Media Count:

16.0

Abstract:

Morphine and fentanyl are frequently used for analgesia after trauma, but there is debate over the advantages and disadvantages of these opioids. Among combat amputees, intravenous IV morphine vs IV fentanyl after injury was associated with reduced likelihood of posttraumatic stress disorder PTSD. The previous results were based on military health diagnoses over 2 yr post-injury. The present study followed psychological diagnoses of patients with amputation for 4 yr using military and Department of Veterans Affairs health data. In theater combat casualty records n 145 documented Glasgow Coma Scale GCS scores andor morphine, fentanyl, or no opioid treatment within hours of injury. We found that 1 GCS scores were not significantly associated with PTSD 2 longitudinal modeling using four yearly time points showed significantly reduced odds of PTSD for patients treated with morphine vs fentanyl across years adjusted odds ratio 0.40 95 confidence interval 0.17-0.94 3 reduced PTSD prevalence for morphine vs IV fentanyl morphine 25, fentanyl 59, p less than 0.05 was significant, specifically among patients with traumatic brain injury during the first 2 yr post-injury and 4 PTSD prevalence, but not other disorders e.g., mood, increased between year 1 PTSD 18 and years 2 through 4 post-injury PTSD range 30-32.

Subject Categories:

  • Psychology
  • Pharmacology
  • Military Forces and Organizations

Distribution Statement:

APPROVED FOR PUBLIC RELEASE