Long Waits in Emergency Rooms Linked to PTSD, Poor Prognosis

While most of us believe stress comes before the heart attack, a new study shows that a long wait in an emergency room can contribute to the development of the symptoms related to post traumatic stress disorder.

Study authors are quick to point out that while a crowded ER does not actually cause PTSD, the hospital environment has the potential to leave a mark on a patient’s health.

“If you go to an urban emergency department on a busy evening, you may have patients piled up in the hallway, patients with substance abuse problems and patients who are mentally ill,” said Benjamin Sun, who studies hospital overcrowding but was not involved with the new study.

“If you are a patient who is very sick and you are getting care under those conditions, you can see why you’d be traumatized,” Sun told Reuters.

The study’s lead author, Donald Edmondson, suggests that the environment in which the patient receives treatment has an impact on the psychological adjustment after the event. Edmondson had completed research in the past that showed one in eight heart attack patients later develops post traumatic stress disorder symptoms.

For the more than 1 million Americans who have a heart attack or chest pain this year,” those overcrowded emergency departments will increase the stress of an already traumatic event, and may lead to increased PTSD symptoms and poor prognosis,” Edmondson said.

The report was published in the Feb. 11 online edition of JAMA Internal Medicine.

To see what effects waiting in crowded emergency rooms might have, Edmondson’s team noted the time when 135 heart patients arrived at a New York City emergency room between 2009 and 2011.

Those who stayed in the emergency room for more than 11 hours were more likely to suffer symptoms of heart disease-related PTSD in the month after their stay, the researchers found.

PTSD symptoms include nightmares, being on edge or jumpy, flashbacks and actively trying to avoid thinking about the symptoms. Such symptoms are tied to a risk of a second heart attack and death within three years.

A 2009 survey found that more than 90 percent of emergency room directors in the U.S. reported overcrowding as a problem several times throughout any given week. This overcrowding leads to increased wait times and is often tied to dissatisfied patients and increases the risk for less than ideal outcomes.