Emergency room crowding tied to ACS-induced PTSD

(HealthDay)—Exposure to emergency department crowding correlates with acute coronary syndrome (ACS)-induced posttraumatic stress disorder (PTSD) symptoms one month after ACS, according to a research letter published online Feb. 11 in JAMA Internal Medicine.

Donald Edmondson, Ph.D., of the Columbia University Medical Center in New York City, and colleagues assessed the degree of emergency department crowding exposure for 135 patients participating in the Prescription Use, Lifestyle, Stress Evaluation observational cohort study who met the criteria for ACS and were admitted through the emergency department. PTSD was assessed one month after ACS.

The researchers found that, in univariate analysis, increasing tertiles of emergency department crowding correlated with one-month ACS-induced PTSD symptoms. This association persisted after adjustment for multiple demographic variables and previous myocardial infarction, Global Registry of Acute Coronary Events mortality risk score, Charlson comorbidity index, left ventricular ejection fraction of 40 percent or higher, and in-hospital Beck Depression Inventory depression score.

"Our results suggest that emergency department crowding may be associated with ACS-induced PTSD symptoms, a risk factor for ACS recurrence and mortality, and a known contributor to poor quality of life, patient satisfaction, and increased medical utilization," the authors write. "Although our results are based on a small sample from a single emergency department, 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 emergency department overcrowding."