Akademik Veri Yönetim Sistemi
ULUSAL TRAVMA VE ACIL CERRAHI DERGISI-TURKISH JOURNAL OF TRAUMA & EMERGENCY SURGERY, cilt.31, sa.12, ss.1236-1246, 2025 (SCI-Expanded, Scopus, TRDizin)
BACKGROUND: This study aims to evaluate the mental health outcomes of orthopedists after the 2023 Kahramanmara & scedil;earth-quakes through a comprehensive analysis based on orthopedic care and amputations. METHODS: This cross-sectional, questionnaire-based study, conducted six months after the 2023 Kahramanmara & scedil;earthquakes, included a total of 95 orthopedists. The online questionnaire assessed demographic characteristics, professional experience, and mental health outcomes using the Impact of Event Scale-Revised (IES-R) and the Depression Anxiety Stress Scale-21 (DASS-21). Scale scores were analyzed according to earthquake zone challenges, orthopedic care provision, and amputation-related stress factors. RESULTS: Care for earthquake victims was provided by 61.5% of orthopedists in the earthquake area, including local (16.8%) and supporting orthopedists (42.1%), while 36.8% treated victims at referral hospitals outside the area. Overall, 76.8% of participants reported performing amputation surgery on earthquake victims. Performing amputations in the pediatric age group (82.2%), witnessing patients' losses or other earthquake-related difficulties (64.4%), and amputations involving multiple extremities (56.2%) were reported as the three most common stress factors related to amputations. Orthopedists at referral hospitals and local orthopedists reported higher total IES-R scores (11.0 [0-58] and 11.5 [0-46] vs. 1.0 [0-39]), as well as higher avoidance (3.0 [0-20] and 3.0 [0-17] vs. 0.0 [0-13]) and intrusion (4.0 [0-20] and 5.0 [0-20] vs. 0.0 [0-14]) subscale scores. Referral hospital orthopedists showed higher anxiety (2.0 [0-13] vs. 0.0 [0-7]), stress (5.0 [0-16] vs. 2.0 [0-12]), and total DASS-21 scores (11.0 [0-44] vs. 6.0 [0-29]) than supporting orthopedists in the disaster zone. Those performing amputations in patients with earthquake-related difficulties reported higher DASS-21 depression scores (4 [0-18] vs. 1 [0-15], p=0.013). IES-R scores were negatively correlated with age (r=-0.203, p=0.049), while other factors showed no correlation with IES-R or DASS-21 scores. CONCLUSION: Our study shows that treating earthquake victims has a significant impact on orthopedists' emotional states and traumatic stress, especially for local and referral hospital orthopedists. The key stress factors included pediatric amputations, multiple extremity amputations, and patient-related difficulties. While tragic events involving relatives did not show a significant association with the scores, performing amputations on patients with earthquake-related difficulties increased depression scores, and younger orthopedists reported higher IES-R scores than older orthopedists. Our findings highlight the need for regular mental health screening, risk group identification, structured psychological support, and resilience training among orthopedic surgeons following large-scale disasters, as well as enhanced preparedness for future emergencies.