Predictive Elements of Trauma and Its After-effects: Importance of the Quality of Neurobiological Response to Stress

Direction Centrale du Service de Santé des Armées130 enrolled

Overview

The neurobiological response to stress is an adaptive response allowing us to cope with the multiple aggressions of daily life. This response orchestrates the body's systemic reaction. The intensity of response to stress can modify the body's functioning, which implies a variety of fields where biomarkers may be isolated: immunity, psychology, neurophysiology, integrative physiology. When stress is too intense or prolonged, response to stress may become misfitted and deleterious. This study is based on the hypothesis that a severe physical or psychological trauma is associated with an intense and misfitted stress that is responsible from an undue immuno-inflammatory activation (through sympathetic activation). The result is a subinvasive state of systemic and tissue inflammation (low-noise inflammation), responsible for the mid-term deleterious consequences of the traumatic event. The objective of this study is to understand how the dysregulation of intense stress simultaneously generates an initial pathological state and an alteration of mid-term evolution (which is considered as a poor prognosis and/or as responsible for after-effects). The investigators wish to identify relevant biomarkers of the mechanisms activated during intense stress and influencing the immuno-inflammatory and epigenetic spheres with deleterious consequences on physiological and psychological functions.

Study Type

OBSERVATIONAL

Enrollment

130

Conditions

Stress Reaction

Interventions

Eligibility

Sex: ALLMin age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Fracture of the upper end of the femur * Cognitive state allowing the understanding of questionnaires Exclusion Criteria: * Traumatic Brain Injury * Chronic inflammatory or immune pathologies * On anticoagulants * On neuroleptic or antidepressant treatment * Pathology or health condition not allowing 1-year survival

Locations (4)

CHU Pellegrin

Bordeaux, France

NOT_YET_RECRUITING

Hôpital d'Instruction des Armées Percy

Clamart, France

NOT_YET_RECRUITING

Hôpital d'Instruction des Armées Bégin

Saint-Mandé, France

NOT_YET_RECRUITING

Hôpital d'Instruction des Armées Sainte-Anne

Toulon, France

RECRUITING

Outcomes

Primary Outcomes

Occurrence of depression

Screening for depression will be done using a validated self-report questionnaire, the Geriatric Depression Scale Short Version (GDS). We will use the threshold value of 10 (score \> or =) which corresponds to a very high probability of depression.

Time frame: 12 months following surgery

Occurrence of "psychosomatic death"

The diagnosis of "psychosomatic death" will be made by a physician. There is no consensus on the diagnosis of this syndrome. However, a patient with "psychosomatic death" is likely to be hospitalized or followed up medically and will not be able to respond to the investigator's request for a telephone interview.

Time frame: 12 months following surgery

Occurrence of death

Vital status will be collected from the participant's family or referring physician or at the birth \& death record service (of the participant's town)

Time frame: 12 months following surgery