Association between post-traumatic stress disorder levels and serum inflammatory factors in patients undergoing digit replantation.

OBJECTIVE

To investigate the levels of early postoperative post-traumatic stress disorder (PTSD) and their association with serum inflammatory factors in patients undergoing digit replantation, and to analyze the influencing factors.

METHODS

A total of 96 patients who underwent digit replantation at Rizhao People's Hospital between March 2022 and December 2024 were enrolled 7 days postoperatively. PTSD levels were assessed using the PTSD Checklist-Civilian Version (PCL-C). Morning fasting blood samples were collected, and serum levels of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, and IL-10 were measured by ELISA. Data were analyzed using univariate analysis, Spearman's correlation, multiple linear regression, and Receiver Operating Characteristic (ROC) curve analysis.

RESULTS

The mean PCL-C score for the 96 patients was 38.21 ± 9.31, with 44 patients (45.83%) presenting PTSD symptoms. Univariate analysis revealed that gender, education level, injury type, complete amputation, involvement of the dominant hand, and number of amputated digits significantly influenced PCL-C scores (p < 0.05). PCL-C scores showed positive correlations with both anxiety and depression scores (r = 0.285 and 0.679, respectively, p < 0.01). Multiple linear regression identified gender, education level, complete amputation, number of injured digits, and levels of anxiety and depression as independent influencing factors for PTSD (p < 0.05). Correlation analysis indicated that PCL-C scores were positively correlated with IFN-γ, TNF-α, IL-1β, and IL-6 levels (r = 0.581, 0.521, 0.552, and 0.507, respectively), and negatively correlated with IL-10 (r = -0.474, p < 0.01). ROC curve analysis suggested that serum inflammatory factors have good predictive value for PTSD.

CONCLUSION

Patients exhibit a certain degree of PTSD in the early stage after digit replantation. Its occurrence is closely associated with female gender, lower education level, severity of the trauma, and co-morbid anxiety and depression, and is significantly correlated with an imbalance between pro-inflammatory and anti-inflammatory serum factors. Serum inflammatory factors may serve as potential biological markers for the early identification of PTSD risk.