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ED overcrowding linked to PTSD in patients with ACS

Monday February 18, 2013
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ED overcrowding may be associated with acute coronary syndrome-induced post-traumatic stress disorder, according to new research.

Such symptoms are a risk factor for ACS recurrence and mortality and a known contributor to poor quality of life, patient satisfaction and increased medical utilization, noted researchers with Columbia University Medical Center in New York City.

The researchers recorded the time of presentation to the ED of a large New York City teaching hospital for 135 patients in the ongoing Prescription Use, Lifestyle, Stress Evaluation study between 2009 and 2011. The average length of stay in the ED was more than 11 hours. The patients’ average age was 63.

After adjusting for a number of factors, the researchers found that increasing amounts of ED crowding were associated with higher ACS-induced PTSD symptoms at one month.

“A mechanism for the association of ED crowding to increased PTSD symptoms may be that a more chaotic environment may foster or inflate perceptions of increased life threat and decreased control, which may in turn contribute to greater acute psychological and physiological arousal,” the researchers wrote.

“Although our results are based on a small sample from a single ED, we believe they suggest the need for greater awareness of the influence of medical environments on patients’ psychological well-being, while underscoring the need for hospital administrators and policymakers to address ED overcrowding.”

The findings appear in a research letter scheduled for publication in JAMA Internal Medicine (formerly the Archives of Internal Medicine). The analysis is available online via subscription or purchase at http://archinte.jamanetwork.com/article.aspx?articleid=1570088.


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