美国纽约大学格罗斯曼医学院精神病学系Katharina Schultebraucks研究组取得最新进展。他们报告了在12个月内预测创伤后应激过程的算法的开发和验证。2020年7月6日，相关论文发表于《自然—医学》。

研究人员使用两个独立收集的来自两个1级急诊创伤中心创伤幸存者的前瞻性队列，来自电子病历的常规可收集数据以及对患者即时应激反应的简短临床评估。结果表明，外部验证的准确性可以高精度地区分创伤后应激障碍（PTSD）风险。尽管该预测算法可在急诊科（ED）患者的两个独立的前瞻性队列中产生有用的可重复性结果，但未来的研究应在常规医疗条件下将其推广到广泛的临床异质ED人群。

据介绍，每年，大约有3000万患者在发生创伤事件后从ED出院。这些患者有严重的精神病风险，约有10–20％会发展一种或多种疾病，包括焦虑症、抑郁症或PTSD。目前，尚无准确的方法来预测创伤后急诊入院后PTSD症状的发展。急诊服务部门需要在治疗时进行准确的风险鉴定，以告知并有针对性地部署治疗措施，以减轻高危人群随后的心理病理状况。

附：英文原文

Title: A validated predictive algorithm of post-traumatic stress course following emergency department admission after a traumatic stressor

Author: Katharina Schultebraucks, Arieh Y. Shalev, Vasiliki Michopoulos, Corita R. Grudzen, Soo-Min Shin, Jennifer S. Stevens, Jessica L. Maples-Keller, Tanja Jovanovic, George A. Bonanno, Barbara O. Rothbaum, Charles R. Marmar, Charles B. Nemeroff, Kerry J. Ressler, Isaac R. Galatzer-Levy

Issue&Volume: 2020-07-06

Abstract: Annually, approximately 30 million patients are discharged from the emergency department (ED) after a traumatic event1. These patients are at substantial psychiatric risk, with approximately 10–20% developing one or more disorders, including anxiety, depression or post-traumatic stress disorder (PTSD)2,3,4. At present, no accurate method exists to predict the development of PTSD symptoms upon ED admission after trauma5. Accurate risk identification at the point of treatment by ED services is necessary to inform the targeted deployment of existing treatment6,7,8,9 to mitigate subsequent psychopathology in high-risk populations10,11. This work reports the development and validation of an algorithm for prediction of post-traumatic stress course over 12 months using two independently collected prospective cohorts of trauma survivors from two level 1 emergency trauma centers, which uses routinely collectible data from electronic medical records, along with brief clinical assessments of the patient’s immediate stress reaction. Results demonstrate externally validated accuracy to discriminate PTSD risk with high precision. While the predictive algorithm yields useful reproducible results on two independent prospective cohorts of ED patients, future research should extend the generalizability to the broad, clinically heterogeneous ED population under conditions of routine medical care.

DOI: 10.1038/s41591-020-0951-z

Source: https://www.nature.com/articles/s41591-020-0951-z