Association of PSQI and SCL-90 scores with early clinical identification of posttraumatic stress disorder after emergency trauma surgery.

OBJECTIVE

To evaluate the association of Pittsburgh Sleep Quality Index (PSQI) and Symptom Checklist-90 (SCL-90) scores with post-traumatic stress disorder (PTSD) identified 1 month after emergency trauma surgery.

METHODS

In this retrospective convenience sample, 98 patients with PTSD identified 1 month after emergency trauma surgery (March 2022 to March 2024) were assigned to the PTSD group, and 110 patients without PTSD were included as the non-PTSD group. Baseline characteristics, Injury Severity Score (ISS), and Post-traumatic Stress Disorder Checklist-Civilian Version (PCL-C) were recorded. PSQI and SCL-90 scores were assessed at the same postoperative time point. ROC analysis was used to evaluate the discriminatory performance and optimal cut-off values of these scores for early clinical identification of PTSD. Correlation analyses examined relationships among PSQI, SCL-90, PCL-C, and ISS. Multivariate logistic regression was used to identify factors independently associated with PTSD. A post hoc power analysis was additionally performed for baseline variables with P > 0.05, and a 1:1 propensity score matching sensitivity analysis was conducted.

RESULTS

The PTSD group had significantly lower proportions of married individuals, those with a bachelor's degree or higher, and those with monthly income >5000 RMB, along with higher ISS and PCL-C scores (all P < 0.05). PSQI and SCL-90 scores were significantly higher in the PTSD group (P < 0.001). The combined PSQI and SCL-90 model showed the largest area under the curve for PTSD identification (AUC = 0.937, 95%CI: 0.895-0.966), with an optimal probability cut-off of 0.462, 89.80% sensitivity, and 84.55% specificity. The optimal cut-off values for PSQI and SCL-90 were 11.5 and 128.5, respectively. PSQI and SCL-90 scores were positively correlated with ISS (r = 0.742 and r = 0.586) and PCL-C scores (r = 0.625 and r = 0.493; all P < 0.001). Multivariate analysis confirmed that education, monthly income, PSQI score, and SCL-90 score were independently associated with PTSD status (all P < 0.05). The matched sensitivity analysis yielded consistent results.

CONCLUSION

PSQI and SCL-90 scores are closely associated with PTSD identified 1 month after emergency trauma surgery. Their combined assessment showed high value for early identification and risk stratification and may support postoperative psychological screening in trauma populations.