BackgroundPost-traumatic stress disorder (PTSD) has debilitating psychiatric and medical consequences. The purpose of this study was to identify whether PTSD diagnosis and PTSD symptom scale score (PTSD severity) could be predicted by assessing peritraumatic experiences using a single question or screening tools at different time points in patients hospitalized after admission to the hospital after significant physical trauma, but with stable vitals (level II trauma).MethodsPatients completed the ‘initial question’ and the National Stressful Events Survey Acute Stress Disorder Scale (NSESSS) at 3 days to 5 days after trauma (NSESSS-1). The same scale was administered 2 weeks to 4 weeks after trauma (NSESSS-2). The Posttraumatic Stress Disorder Symptoms Scale Interview for DSM-5 (PSSI-5) was administered 2 months after trauma. PTSD diagnosis and PTSD severity were extracted from the PSSI-5. Linear multivariate regression analyses were used to establish whether scores for NSESSS-1 or NSESSS-2 predicted PTSD diagnosis/PTSD severity. Non-linear multivariate regression analyses were performed to better understand the relationship between NSESSS-1/NSESSS-2 and PTSD diagnosis/PTSD severity.ResultsA single question assessing the experience of fear, helplessness, or horror was not an effective tool for determining the diagnosis of PTSD (p=0.114) but can be a predictor of PTSD severity (p=0.039). We demonstrate that administering the NSESSS after either 3 days to 5 days (p=0.008, p<0.001) or 2 weeks to 4 weeks (p=0.039; p<0.001) can predict the diagnosis of PTSD and PTSD severity. Scoring an NSESSS above 14/28 (50%) increases the chance of experiencing a higher PTSD severity substantially and linearly.DiscussionOur initial question was not an effective predictor of PTSD diagnosis. However, using the NSESSS at both 3 days to 5 days and 2 weeks to 4 weeks after trauma is an effective method for predicting PTSD diagnosis and PTSD severity. Additionally, we show that patients who score higher than 14 on the NSESSS for acute stress symptoms may need closer follow-up.Level of evidenceLevel III, prognostic.

Cranioplasty is the surgical repair of a bone deformity of the skull. Autologousbone grafts are preferred more since the cranial bone flaps will not be subject to rejection bythe host and they lower the entry of foreign materials into the body. Preservation of cranialbone flaps is done in numerous ways, namely cryopreservation after a decompressivecraniectomy, intracorporeal preservation and cranioplasty with subcutaneously preservedautologous bone grafts. The method of preserving cranial bone flaps using cryopreservationhas many advantages; it is a safe, simple and an effective method for autologous bone grafts.The cryopreservation is also associated with higher infection rates and bone resorption ascomplications when compared to intracorporeal preservation. Intracoporeal preservationtechnique has many advantages, particularly that this surgery is easy, safe and cost-effective.The duration of the operation is short. The autologous bone flaps are not subject to rejectionand there is no need for intra-operative bone shaping. Therefore on the basis of review ofliterature authors concluded that intracorporeal preservation is better than cryopreservation ofcranial bone flaps, in terms of efficacy and complications.