Insights from patient experience: An analysis of free text comments from the advancing understanding of recovery after trauma (AURORA) study

Background and Objectives: AURORA (Advancing Understanding of RecOvery afteR traumA) is a large trial looking at psychophysical, physiological, neurocognitive factors, genomic, neuroimaging, and self-report data. No large prospective studies have thoroughly evaluated adverse posttraumatic neuropsychiatric sequelae (APNS) for months following discharge. APNS includes outcomes such as posttraumatic stress disorder (PTSD), depression, regional or widespread pain. However, APNS is multidimensional and the global burden of pain after trauma is not completely understood. The objective is to evaluate the frequency that patients report APNS symptoms when presented with free-text questions about their experiences after trauma. Methods: Adult, English speaking patients with a smart phone were eligible for enrollment. Free-text comments from 8 week and 3 months post trauma are available. Responses were analyzed to find common themes and the largest themes were quantified for what is most important for researchers to understand about your experience since the trauma. Results: Of 1618 patients, 66.32% provided a written comment (n =350 blanks, n =195 n/a) at 8 wks and 60.32% (n=488 blanks, n=154 n/a) at 3 months. Most 78% (1255) experienced motor vehicle collision, 10% (155) were assaulted, 64% (1035) were female and most 67% (1089) were non-white. The most common themes were: symptomatic complaints at 11.7% (126); pain (55%); and mental health (33%). Emotional complaints 8.9% (95); stress (27.3%), anxiety (22.1%), and fear/scared (21.0%). PTSD and/or thoughts of trauma occurred in 5%, while 4.7% noted resources such as support and financial issues. At 3 months symptomatic complaints 8.9% (96); pain (54%), mental health concerns (21.9%), and emotional complaints 7.5% (80); stress (28.8%), anxiety and depression (7.5%). PTSD and/or thoughts of trauma (5.5%) which was slightly higher than noted at 8wks. Resources issues were less common at 3 months seen in 2.0% of patients. Conclusion: This study provides supplementary information regarding the picture of APNS and can help physicians more fully understand the burden of disease after trauma