Posttraumatic Stress Disorder Risk Assessment in Craniofacial Trauma at a Level 1 Trauma Center

Background: Traumatic craniofacial injuries result in negative psychological sequelae. This study aimed to analyze Injured Trauma Survivor Screen (ITSS) results to assess posttraumatic stress disorder (PTSD) risk in traumatic craniofacial injuries and identify corresponding factors that may contribute to increased risk. Methods: In a retrospective cohort analysis, all patients with craniofacial fractures, identified via International Classification of Diseases, 10th Revision codes, who were screened with the ITSS survey at a single level 1 trauma center from June 2022 to January 2024 were included. Results: Two hundred forty-eight patients met the inclusion criteria (median age 54 y; interquartile range: 33.0–72.5 y; 66.1% men); 22.9% of patients screened positive for PTSD risk. With every 1-day increase in length of stay, the odds of a positive PTSD risk score were 1.08 times that of a negative PTSD risk score (odds ratio [OR] 1.08; 95% confidence interval [CI]: 1.03–1.13; P = 0.0022). Hispanic patients had higher odds of a positive PTSD risk score compared with White patients (OR 5.24; 95% CI: 2.03–13.54; P = 0.0086). Injury via assault had greater odds of a positive PTSD risk score compared with ground-level fall (OR 6.65; 95% CI: 1.80–24.54; P = 0.0162). Conclusions: Craniofacial trauma carries a similar risk of PTSD to the general trauma population. Increased length of stay, Hispanic race, and injury via assault are patient characteristics that can raise suspicion for PTSD risk in this trauma population, especially at centers that do not make use of the ITSS.