Dataset Information

Predictors and severity of probable acute stress disorder following the Beirut Port Blast.

ABSTRACT:

Background

The Beirut Port Blast on August 4, 2020 is the largest (non-nuclear) explosion on record. St George Hospital University Medical Center (SGHUMC), a leading academic medical centre in Lebanon, adjacent to the Port, sustained a massive loss in lives and infrastructure.

Objective

The current study uses the baseline data of an ongoing longitudinal study to explore the prevalence, severity, and predictors of probable Acute Stress Disorder (ASD) among health workers at SGHUMC following the blast.

Methods

In the context of COVID-19 tests administered 9-15 days after the blast, SGHUMC staff were asked to complete a questionnaire that included socio-demographic details, the Beirut Port Exposure Inventory, and the Acute Stress Disorder Scale (ASDS).

Results

A total of 570 health workers participated in the study. The prevalence of probable DSM-5 ASD [95%CI] was 38.34% [31.41; 45.32]. Many specific exposures were related, on a bivariate level, to ASD be it as a probable DSM-5 diagnosis or its severity as measured by the ASDS. A classification and regression tree (CART) analysis identified the highest risk predictors of probable DSM-5 ASD diagnosis to be: being a female, seeing dead or mutilated bodies, death of a close one, and being scared at the time of the explosion. Nurses carried the highest risks of all health workers with a probable DSM-5 ASD prevalence of 51.28%, (OR = 3.72 [95% CI: 2.22; 6.25]). Being scared at the time of the blast was the most single predictor of probable ASD.

Conclusion

Both the prevalence and severity of probable DSM-5 ASD in this sample are higher than most reported in the literature, which may be explained by the severity of the trauma and the ongoing stress in the context of the pandemic. Fear at the time of the explosion was independently the most predictive parameter of probable ASD.

SUBMITTER: Karam E

PROVIDER: S-EPMC8942494 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Predictors and severity of probable acute stress disorder following the Beirut Port Blast.

Karam Elie E Saab Dahlia D Al Barathie Josleen J Karam Aimee Nasser AN Karam George G Bryant Richard R

European journal of psychotraumatology 20220322 1

<h4>Background</h4>The Beirut Port Blast on August 4, 2020 is the largest (non-nuclear) explosion on record. St George Hospital University Medical Center (SGHUMC), a leading academic medical centre in Lebanon, adjacent to the Port, sustained a massive loss in lives and infrastructure.<h4>Objective</h4>The current study uses the baseline data of an ongoing longitudinal study to explore the prevalence, severity, and predictors of probable Acute Stress Disorder (ASD) among health workers at SGHUMC ...[more]

PMID: 35340788

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Project description:ImportanceA review of the injury patterns, treatment strategies, and responding physicians' experience during the Port of Beirut blast may help guide future ophthalmic disaster response plans.ObjectiveTo present the ophthalmic injuries and difficulties encountered as a result of the Port of Beirut blast on August 4, 2020.Design, setting, and participantsA retrospective medical record review of all patients who presented to the emergency department and 13 ophthalmology outpatient clinics at the American University of Beirut Medical Center for treatment of ophthalmic injuries sustained from the explosion in Port of Beirut, Beirut, Lebanon, from August 4 to the end of November 2020. Patients were identified from emergency records, outpatient records, and operative reports.Main outcomes and measuresTypes of ocular injuries, final best-corrected visual acuity, and need for surgical intervention were evaluated. Visual acuity was measured with correction based on noncycloplegic refraction using the Snellen medical record.ExposuresOcular or ocular adnexal injuries sustained from the Port of Beirut explosion.ResultsA total of 39 blast survivors with ocular injuries were included in this study. Twenty-two patients presented with ocular injuries on the day of the blast, and 17 patients presented within the following 3 months to the ophthalmology clinics for a total of 48 eyes of 39 patients were treated secondary to the blast. Thirty-five patients (89.6%) were adults, and 24 (61.5%) were female. A total of 21 patients (53.8%) required surgical intervention, more than half of which were urgently requested on the same day of presentation (14 [35.9%]). Most eye injuries were caused by debris and shrapnel from shattered glass leading to surface injury (26 [54.2%]), eyelid lacerations (20 [41.6%]), orbital fractures (14 [29.2%]), brow lacerations (10 [20.8%]), hyphema (9 [18.8%]), open globe injuries (10 [20.8%]), and other global injuries. Only 7 injured eyes (14.5%) had a final best-corrected visual acuity of less than 20/200, including all 4 open globe injuries with primary no light perception (8.3%) requiring enucleation or evisceration.Conclusions and relevanceIn the aftermath of the Port of Beirut explosion, a review of the ophthalmic injuries showed a predominance of shrapnel-based injuries, many of which had a delayed presentation owing to the strain placed on health care services. Reverting to basic approaches was necessary in the context of a malfunctioning electronic medical record system.

Project description:Background Accumulative evidence indicates a role for adiponectin, a polypeptide secreted by adipose tissue, in the pathophysiology of posttraumatic disorder (PTSD) via metabolic and inflammatory pathways. This study examined adiponectin as a potential predictive biomarker for PTSD among female rape survivors. Methods We evaluated the relationship of baseline serum adiponectin levels to the development of probable PTSD at 3- and 6-months post rape-exposure and compared adiponectin levels between 542 rape-exposed (RE) and 593 rape-unexposed women (RUE). Probable PTSD were defined as Davidson Trauma Scale score ≥40. Data were analysed using multivariate regression models and a generalized estimating equation (GEE) model. We adjusted for clinically relevant covariates associated with PTSD, as well as adiposity indices. Results Participants who were in the mid-and high adiponectin tertile groups versus the lowest tertile group had a significantly reduced risk of probable PTSD among at 6 months follow-up, independent of adiposity(aOR = 0.45[0.22–1.05], p = 0.035; aOR = 0.44[0.22–0.90], p = 0.024). However, there was no effect of group (RE vs. RUE). Limitations Adiponectin assays were conducted on non-fasting blood samples and information on chronic medication, dietary factors and levels of physical activity were not collected. There was a high attrition rate among rape exposed participants. Conclusions Our results show that higher serum adiponectin levels are associated with reduced risk of probable PTSD over a 6-month period. This finding supports the hypothesis that serum adiponectin is a potential risk biomarker for PTSD. Highlights • The prospective associations between adiponectin, an anti-inflammatory cytokine and development of PTSD was examined in a cohort of rape exposed women.• Serum adiponectin levels were inversely associated with probable PTSD at 6 month among control but not rape exposed women.• Results suggest that adiponectin may serve as a potential risk biomarker of PTSD.

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Dataset Information

Predictors and severity of probable acute stress disorder following the Beirut Port Blast.

Background

Objective

Methods

Results

Conclusion

Publications

Predictors and severity of probable acute stress disorder following the Beirut Port Blast.

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