This study examined the modifying effects of surgery status on the association between the Standard Deviation of NN Intervals (SDNN) of the heart rate variability and the post-traumatic stress disorder (PTSD) development. Participants with physical injury were recruited from a trauma center and followed for two years. Baseline assessment included SDNN and surgery status. Socio-demographic and clinical covariates were collected. PTSD was diagnosed at 3, 6, 12, and 24 months post-injury using the Clinician-Administered PTSD Scale for DSM-5. Logistic regression analyses were performed. Among 538 participants, 58 (10.8%) developed PTSD during the study, with prevalence rates of 8.4% at 3 months, 6.5% at 6 months, 4.7% at 12 months, and 2.5% at 24 months. A significant modifying effect was found that lower SDNN were significantly associated with PTSD in non-surgical patients but not in surgical patients, with significant interaction terms. This pattern was observed from 3 to 12 months but not at 24 months. Surgery-dependent associations between SDNN and PTSD development were observed, highlighting the need for tailored PTSD prevention strategies considering SDNN and surgery status.
Keywords: Heart rate variability; Longitudinal study; Posttraumatic stress disorder; SDNN; Surgery.
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