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Functional Limitations among Responders to the World Trade Center Attacks 14 years After the Disaster: Implications of Chronic Posttraumatic Stress Disorder

机译：灾难发生14年后应对世界贸易中心袭击事件的响应者的功能局限性：慢性创伤后应激障碍的影响

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Posttraumatic stress disorder (PTSD) is associated with self-reported difficulties navigating the social and physical world and may also be associated with risk of functional limitations. The Short Physical Performance Battery (SPPB), an objective functional assessment, was administered during monitoring exams between January and December 2015 to a consecutive sample of 1,268 rescue workers, volunteers, and other responders who aided in response, recovery, and cleanup efforts at the World Trade Center (WTC) in New York after the September 11, 2011 attacks. Data were linked with diagnostic and longitudinal data from the WTC monitoring study. Multivariable analyses were used to examine predictors of functional limitations. Prevalence estimates weighted to the general responder population revealed a relatively high prevalence of functional limitations, SPPB ≤ 9; 16.0%, 95% CI [13.7, 18.4]. Current PTSD was associated with a two-fold increased risk of functional limitations after controlling for predisposing factors, trauma severity, behavioral factors, and WTC-related medical conditions, Adjusted Risk Ratio (aRR) = 2.11, 95% CI [1.48, 3.01]. Exposure to ergonomic risk factors at the WTC also increased the risk of functional impairments, aRR=1.34 95% CI [1.05, 1.70]. Longitudinal results suggest that individuals with current functional limitations experienced high baseline PTSD severity, B = 2.94, SE=1.33, and increasing PTSD symptom severity, B = 0.29, SE = 0.10, since September 11, 2001. This study identified a cross-sectional relationship between functional limitations and PTSD and a worsening of PTSD symptoms in persons who eventually demonstrate functional limitations. Results highlight the potential role of chronic PTSD in functional limitations.
机译：创伤后应激障碍（PTSD）与自我报告的在社交和身体世界中的导航困难有关，也可能与功能受限的风险有关。在2015年1月至12月期间的监测考试中，对1268名救援人员，志愿者和其他响应者进行了连续的抽样调查，目的是对客观的身体评估（SPPB）进行一次客观的功能评估，以帮助他们进行响应，恢复和清理工作。在2011年9月11日袭击之后，纽约世界贸易中心（WTC）。数据与来自WTC监测研究的诊断和纵向数据相关联。多变量分析用于检查功能受限的预测因素。加权为一般应答人群的患病率估计显示功能限制患病率相对较高，SPPB≤9； 16.0％，95％CI [13.7，18.4]。在控制了易患因素，创伤严重程度，行为因素以及与WTC相关的医疗条件之后，当前的PTSD与功能受限风险增加了两倍有关，调整后的风险比（aRR）= 2.11，95％CI [1.48，3.01] 。在世贸中心接触人体工程学危险因素也增加了功能障碍的风险，aRR = 1.34 95％CI [1.05，1.70]。纵向结果表明，自2001年9月11日以来，当前功能受限的个体经历了较高的基线PTSD严重程度，B = 2.94，SE = 1.33，并且PTSD症状严重程度增加，B = 0.29，SE = 0.10。该研究确定了横断面功能障碍与PTSD之间的关系以及最终表现出功能障碍的人中PTSD症状的恶化。结果突出了慢性创伤后应激障碍在功能限制中的潜在作用。

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