A systematic review and meta-analysis of the prevalence of post-traumatic stress disorder (PTSD) in road traffic accident survivors.

Background: This systematic review and meta-analysis aimed to evaluate the prevalence of post-traumatic stress disorder (PTSD) among road traffic accident (RTA) survivors, a demographic impacted by over 50 million disabilities globally each year. Methods: An initial systematic search was conducted in November 2021, with an updated search performed in October 2024. Relevant databases were comprehensively searched using keywords related to "traffic accidents," "road accidents," "motor vehicle accidents," "PTSD," and "Post-Traumatic Stress Disorder." This systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 guidelines and the PICO framework established by Cochrane. The review included studies that involved RTA survivors diagnosed with PTSD, focusing on time frames from one to six months post-accident and utilizing DSM criteria. Eligible studies were reviewed for quality using the standardized critical appraisal instruments from the Joanna Briggs Institute (JBI) Checklist, by two independent reviewers. Meta-analysis was performed using Comprehensive Meta-Analysis statistical software and STATA16 to estimate overall prevalence rates and subgroup analyses to explore variations. Results: A comprehensive search across multiple databases identified 11,142 articles, of which 92 were reviewed, and 82 were included in the meta-analysis. The findings revealed an overall PTSD prevalence of 20.3% (95% confidence interval [CI]: 18.1%-22.8%; I2: 93.86%); 18.7% (95% CI: 16.0%-21.8%; I2: 93.47%) based on clinician-administered assessments and 22.8% (95% CI: 18.8%-27.3%; I2: 93.92%) from self-reported questionnaires. After removing outliers, the total prevalence was decreased to 18.1% (95% CI: 15.4%-21.0%; I2: 93.09%), in clinician-administered and 20.8% (95% CI: 17.5%-24.4%; I2: 91.51%) in self-reported questionnaires. Notably, the prevalence was 29.4% (95% CI: 22.4%-37.5%) one-month post-RTA, decreasing to 18.8% (95% CI: 14.8%-23.5%); P<0.001 at three months. Age did not significantly predict PTSD prevalence rates. The quality assessment of the studies included demonstrated moderate to high quality according to the Joanna Briggs Institute standards, ensuring the reliability of the findings. Geographic variability in PTSD prevalence was observed, with lower rates reported in Switzerland, Australia, Germany, and Japan, while higher rates were found in Spain, China, and Iran. Conclusion: This review highlights a significant PTSD prevalence of 20.3% among traffic accident survivors, emphasizing the need for early intervention and targeted mental health support to mitigate long-term psychological impacts and improve recovery outcomes in this vulnerable population. Screening and public awareness of disease symptoms are recommended.