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Health Status Perception and Psychological Sequelae in Buried Victims: An Observational Study on Survivors of the Earthquake in Amatrice (Italy), Three Years Later

Published online by Cambridge University Press:  20 February 2023

Emiliano Petrucci Open the ORCID record for Emiliano Petrucci [Opens in a new window] ,
Vincenza Cofini ,
Barbara Pizzi ,
Giacomo Sollecchia ,
Marco Cascella ,
Necozione Stefano ,
Alessandro Vittori Open the ORCID record for Alessandro Vittori [Opens in a new window]  and
Franco Marinangeli
Emiliano Petrucci*
Affiliation:
Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L’Aquila, L’Aquila, Italy
Vincenza Cofini
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
Barbara Pizzi
Affiliation:
Department of Anesthesia and Intensive Care Unit, SS Filippo and Nicola Academic Hospital of Avezzano, L’Aquila, Italy
Giacomo Sollecchia
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
Marco Cascella
Affiliation:
Department of Anesthesia and Critical Care, Istituto Nazionale Tumori, IRCCS, Fondazione Pascale, Naples, Italy
Necozione Stefano
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
Alessandro Vittori
Affiliation:
Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Rome, Italy
Franco Marinangeli
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
*
Correspondence: Emiliano Petrucci, MD Department of Anesthesia and Intensive Care Unit San Salvatore Academic Hospital of L’Aquila L’Aquila, Italy E-mail: petrucciemiliano@gmail.com
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Abstract

Introduction:

The extrication from rubble is particularly critical for the survival of the victims of an earthquake. Early repeated infusion of sedative agents (SAs) in the acute trauma phase may interfere with neural processes leading to posttraumatic stress disorder (PTSD).

Study Objective:

This study aimed to analyze the psychological status reported by the buried victims of the earthquake in Amatrice (August 24, 2016; Italy) by considering type of the SAs administered during the extrication maneuvers.

Methods:

This was an observational study on data from 51 patients directly rescued under the rubble during the earthquake in Amatrice. During extrication maneuvers, a moderate sedation was administered by titrating ketamine (0.3-0.5mg/kg) or morphine (0.1-0.15mg/kg) with respect to the Richmond Agitation and Sedation Scale (RASS; between -2 and -3) in buried victims.

Three years following the rescue, the survivors were interviewed on their perceived health status and stress using a questionnaire which consisted of 17 items: the standard four-item set of healthy days core questions (CDC HRQOL-4); the 12-item General Health Questionnaire (GHQ-12); and in addition, survivors were asked if they had a diagnosis for anxiety, depression, or for PTSD.

Results:

The study analyzed data from the complete clinical documentation of 51 survivors; 30 were males and 21 females, with an average age of 52 years. Twenty-six (26) subjects were treated with ketamine, while 25 were treated with morphine, during the extrication procedures. Concerning the quality-of-life analysis, only 10 survivors out of 51 perceived their health status as good; the others reported psychological disorders. The GHQ-12 scores showed that all survivors had psychological distress with a mean total score of 22.2 (SD = 3.5). Eighteen (18) victims declared to have had a diagnosis of generalized anxiety (35%), while 29 were treated for depression (57%) and PTSD (57%) by a specialist. With regards to the perceived distress level and the anxiety disorder, this analysis showed significant associations with SAs used during extrication, with a better performance for ketamine than for morphine.

Conclusion:

These findings suggest investigating whether early sedation with ketamine directly in the disaster setting may promote the prophylaxis and reduce the risk of developing trauma-related disorders (TRDs) on the buried victims of major natural disasters in future studies.

Keywords

burialnatural disastersedative agentstrauma-related disorders
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 38 , Issue 2 , April 2023 , pp. 193 - 198
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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