Mette Ratzer

Bio: Mette Ratzer is an academic researcher from University of Southern Denmark. The author has contributed to research in topics: Intensive care & Intensive care unit. The author has an hindex of 2, co-authored 2 publications receiving 38 citations. Previous affiliations of Mette Ratzer include Aarhus Municipality.

Posttraumatic stress in intensive care unit survivors – a prospective study

Abstract: Aims: This study aimed to estimate the prevalence of severe Posttraumatic Stress Disorder (PTSD) symptoms and to identify factors associated with PTSD in survivors of intensive care unit (ICU) treatment following traumatic injury. Methods: Fifty-two patients who were admitted to an ICU through the emergency ward following traumatic injury were prospectively followed. Information on injury severity and ICU treatment were obtained through medical records. Demographic information and measures of acute stress symptoms, experienced social support, coping style, sense of coherence (SOC) and locus of control were assessed within one-month post-accident (T1). At the six months follow-up (T2), PTSD was assessed with the Harvard Trauma Questionnaire (HTQ). Results: In the six months follow-up, 10 respondents (19.2%) had HTQ total scores reaching a level suggestive of PTSD (N = 52), and 11 respondents (21%) had symptom levels indicating subclinical PTSD. Female, five illness factors: coma time, mechanical ventilatio...

Posttraumatic Stress Disorder in Patients Following Intensive Care Unit Treatment: A Review of Studies Regarding Prevalence and Risk Factors

Abstract: Charcot spine, also known as neuropathic spinal arthropathy and Charcot spinal arthropathy, is a rare and potentially devastating consequence of spinal cord injury. Treatment of this condition ranges from observation, immobilization with bracing or jacket, or surgical stabilization. A 52-year-old male, with a history of a C6-7 spinal cord injury over 30 years ago, presented to our hospital with complaints of worsening of his chronic low back pain over the prior 6 months. His pain was exacerbated with movement, and he also found it more difficult to sit up straight in his wheelchair. MR imaging of the spine demonstrated the large fluid collection with transection of the thecal sac and spinal cord at T10-11, along with the prior known spinal cord injury at C6-7. Given the patient’s clinical presentation and signs of progressive degenerative changes with worsening kyphosis, the patient underwent a T7- L3 posterior instrumented fusion for stabilization. Through the same incision, an extracavitary approach was utilized for placement of an expandable titanium case for anterior column support. After the operation, he experienced a significant reduction in pain and noted improved posture in his wheelchair

A recovery program to improve quality of life, sense of coherence and psychological health in ICU survivors: a multicenter randomized controlled trial, the RAPIT study

Abstract: The aim of this randomized controlled trial (RCT) was to test the effectiveness of a post-ICU recovery program compared to standard care during the first year after ICU discharge. A pragmatic, non-blinded, multicenter, parallel-group RCT was conducted between December 2012 and December 2015, at ten intensive care units (ICUs) in Denmark. We randomly assigned 386 adult patients (≥18 years) after receiving mechanical ventilation (≥48 h) to standard care (SC) plus a nurse-led intensive care recovery program or standard care alone after ICU discharge (190 intervention, 196 SC). Primary outcome was health-related quality of life (HRQOL) at 12 months. Secondary outcomes were sense of coherence (SOC), anxiety, depression, and post-traumatic stress disorder (PTSD) assessed at 3 and 12 months after ICU discharge including utilization of healthcare services at 12 months. At 12 months, we found no differences in HRQOL between groups (mean difference in the Physical Component Summary score, 1.41 [95 % CI, −1.53 to 4.35; p = 0.35] (n = 235); and in the Mental Component Summary score, 1.92 [95 % CI, −1.06 to 4.90; p = 0.11] (n = 235). No differences were found on self-reported SOC (p = 0.63), anxiety (p = 0.68), depression (p = 0.67), PTSD (p = 0.27), or the utilization of healthcare services including rehabilitation. We found a difference on anxiety, when a cut-off point ≥11 was applied, in per protocol analysis of complete cases at 3 months favoring the intervention (8.8 % vs. 16.2 %, p = 0.04). The tested recovery program was not superior to standard care during the first 12 months post-ICU. The trial is registered at Clinicaltrials.gov, identification no. NCT01721239.

ASD and PTSD in rape victims

Abstract: In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims shortly after the rape or attempted rape. The PTSD diagnosis based solely on the three core symptom clusters was best identified by a subclinical ASD diagnosis based on all ASD criteria except dissociation. However, a full PTSD diagnosis including the A 2 and F criteria was best identified by classifying victims according to a full ASD diagnosis. Regardless of whether cases were classified according to full PTSD status or according to meeting the criteria for the three PTSD core symptom clusters, the classification was correct only in approximately two thirds of the cases. A regression analysis based on ASD severity and sexual problems following the rape accounted for only 28% of the PTSD severity variance. In conclusion, the ASD diagnosis is not an optimal method for identifying those most at risk for PTSD. It remains to be seen whether a better way can be found.

The relationship between sense of coherence and post-traumatic stress: a meta-analysis.

Abstract: Background: Antonovsky’s concept of sense of coherence (SOC) – as a global orientation reflecting an individual’s feeling of confidence in both the predictability of their internal and external env...

Benzodiazepine Use and Neuropsychiatric Outcomes in the ICU: A Systematic Review*

Abstract: Objectives:A systematic assessment of the role of benzodiazepine use during ICU stay as a risk factor for neuropsychiatric outcomes during and after ICU admission.Data Sources:PubMed/Medline, EMBASE, The Cochrane Library, CINAHL, and PsychINFO.Study Selection:Databases were searched independently by