If a trauma patient is tachycardic, should we call for a counsellor?
BACKGROUND
It has been suggested in the literature that raised heart rate in the early period after trauma is associated with the development of post-traumatic psychopathology, but little account has been taken of the potential confounding effect of injury severity.


MATERIALS AND METHODS
A cohort of 154 patients, studied as part of a wider investigation of trauma outcomes, was included. Initial heart rate in the accident & emergency department, and injury severity score and new injury severity scores were recorded. Patients completed the General Health Questionnaire (GHQ-28) as a measure of psychopathology at presentation and again at two- and six-month follow-up.


RESULTS
There was no relationship between psychopathology at presentation and initial heart rate or injury severity. Raised heart rate was associated with post-traumatic psychopathology at two months but not at six months. When the potential confounding effect of injury severity was controlled for, there was no independent correlation between heart rate and post-traumatic psychopathology. Injury severity score and new injury severity scores were strongly associated with GHQ-28 caseness.


CONCLUSION
Post-traumatic tachycardia is not associated with development of psychopathology, but injury severity is. Previous studies that have suggested a link between tachycardia and development of psychopathology are flawed because they have not considered the confounding effect of severity of injury.
['Sutherland|A G|AG|', 'Senthilkumaran|S|S|', 'Alexander|D A|DA|', 'Hutchison|J D|JD|']
D000293:Adolescent D000328:Adult D000368:Aged D015331:Cohort Studies D000072117:Counselors D005260:Female D006801:Humans D015601:Injury Severity Score D016014:Linear Models D008297:Male D008875:Middle Aged D011569:Psychiatric Status Rating Scales D013610:Tachycardia D013997:Time Factors D014947:Wounds and Injuries D055815:Young Adult
Trauma psychopathology outcomes tachycardia