Effect of Etomidate on Post-Traumatic Stress Disorder After Surgery in Emergency Trauma Patients: A Prospective Cohort Study

Objective To explore the impact of etomidate on the risk of post-traumatic stress disorder (PTSD) occurrence in emergency trauma patients during anesthesia induction through a single-center prospective cohort study. Method This single-center prospective observational cohort study enrolled patients aged 18–60 years who underwent emergency trauma general anesthesia at the Third Hospital of Hebei Medical University from January 2025 to June 2025. Individuals with traumatic brain injury or pre-existing neurological/psychiatric disorders were excluded. Participants were stratified into the etomidate group and propofol group according to the intravenous induction agent. 1:1 Propensity score matching(PSM) was performed to balance baseline confounders including age, injury severity, hemodynamic status and family support. PTSD symptoms were evaluated at 1 and 3 months postoperatively using the PTSD Checklist for DSM-5 (PCL-5), a PCL-5 score > 33 was defined as positive PTSD screening. All statistical analyses were conducted with SPSS 27.0 software. Results A total of 300 eligible patients were initially enrolled (150 per group). After PSM, 116 matched patient pairs were retained for final analysis; standardized mean differences (SMD) of all baseline covariates were less than 0.1, indicating satisfactory between-group balance. At 1-month postoperative, no significant intergroup differences were detected in PCL-5 total scores or PTSD screening positive rates (all P  > 0.05). At postoperative 3 months, patients induced with etomidate had markedly lower PCL-5 scores ( P  < 0.001) and a significantly decreased risk of positive PTSD screening (OR = 0.52, 95%CI 0.28–0.97, P  = 0.038). Conclusion In emergency trauma patients receiving general anesthesia, induction using etomidate is associated with a reduced long-term risk of PTSD, supporting its favorable clinical application prospect.