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Am J Surg. 2019 Mar 7. pii: S0002-9610(19)30139-4. doi: 10.1016/j.amjsurg.2019.03.002. [Epub ahead of print]

Prevalence of posttraumatic stress disorder (PTSD) in patients with an incisional hernia.

Author information

1
Comprehensive Hernia Center, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA. Electronic address: alkhath2@ccf.org.
2
Comprehensive Hernia Center, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.

Abstract

BACKGROUND:

We investigate the prevalence of PTSD in patients with an incisional hernia presenting for evaluation at our institution.

METHODS:

Study patients were screened for PTSD using the PCL-5 checklist for DSM-5. Patient-reported quality of life and pain scores were assessed using validated tools (HerQLes and PROMIS Pain Intensity 3a survey).

RESULTS:

The prevalence of PTSD in 131 patients was 32.1% [95% CI 24%-40%]. Patients screening positive (PTSD+) reported lower quality of life scores on HerQles (17.3 ± 14.3 vs. 47.7 ± 29.6, P < 0.001), and higher pain scores on the PROMIS scale (54.2 ± 9.1 vs. 44.2 ± 10, p < 0.001). PTSD + patients also reported significantly higher numbers of previous hernia repairs and abdominal operations, as well as a higher rate of a history of an open abdomen.

CONCLUSION:

Our study found a significant prevalence of positive screening for PTSD in patients seeking consultation regarding an incisional hernia. We have begun routine preoperative evaluations by a behavioral medicine specialist to address some of these complex issues in high-risk patients. Other high volume hernia programs caring for this challenging patient population should consider such assessments.

KEYWORDS:

Incisional hernia; Mental illness; PTSD; Posttraumatic stress disorder; Quality of life

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