A retrospective study of ketamine administration and the development of acute or post‐traumatic stress disorder in 274 war‐wounded soldiers1. (3rd October 2017)

• Record Type: Journal Article
• Authors: Mion, G.; Le Masson, J.; Granier, C.; Hoffmann, C.
• Is Part Of: Anaesthesia. Volume 72:Number 12(2017:Dec.)
• Page Start: 1476
• Page End: 1483
• Publication Date: 2017-10-03
• Subjects: ketamine -- post‐traumatic stress disorder -- stress disorders -- war; Anesthesia -- Periodicals; 617.96
• DOI: 10.1111/anae.14079
• Languages: English
• ISSNs: 0003-2409

Abstract

Summary: The objective of this study was to explore whether ketamine prevents or exacerbates acute or post‐traumatic stress disorders in military trauma patients. We conducted a retrospective study of a database from the French Military Health Service, including all soldiers surviving a war injury in Afghanistan (2010–2012). The diagnosis of post‐traumatic stress disorder was made by a psychiatrist and patients were analysed according to the presence or absence of this condition. Analysis included the following covariables: age; sex; acute stress disorder; blast injury; associated fatality; brain injury; traumatic amputation; Glasgow coma scale; injury severity score; administered drugs; number of surgical procedures; physical, neurosensory or aesthetic sequelae; and the development chronic pain. Covariables related to post‐traumatic and acute stress disorders with a p ≤ 0.10 were included in a multivariable logistic regression model. The data from 450 soldiers were identified; 399 survived, of which 274 were analysed. Among these, 98 (36%) suffered from post‐traumatic stress disorder and 89 (32%) had received ketamine. Fifty‐four patients (55%) in the post‐traumatic stress disorder group received ketamine vs. 35 (20%) in the no PTSD group (p < 0.001). The 89 injured soldiers who received ketamine had a median (IQR [range]) injury severity score of 5 (3–13 [1–26]) vs. 3 (2–4 [1–6] in the 185 patients who did not (p < 0.001). At multivariable analysis, only acute stress disorder and total number of surgical procedures were independently associated with the development of post‐traumatic stress disorder. In this retrospective study, ketamine administration was not a risk factor for the development of post‐traumatic stress disorder in the military trauma setting.