SelectedWorks - Niels Rathlev MD

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Selected Works of Niels Rathlev MD

Department of Emergency Medicine

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About Niels Rathlev MD

Present	Physician, Baystate Health ‐ Department of Emergency Medicine
Institution Organization Position Type Position Title Time Period to Options Current Position Affiliate my profile with this Institution

Medicine and Health Sciences

Baystate Medical Center 759 Chestnut St.
Springfield, MA

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Association between microbiome and the development of adverse posttraumatic neuropsychiatric sequelae after traumatic stress exposure (Niels Rathlev) All Scholarly Works (2023)

Patients exposed to trauma often experience high rates of adverse post-traumatic neuropsychiatric sequelae (APNS). The biological mechanisms promoting APNS are currently unknown, but the microbiota-gut-brain axis offers an avenue to understanding mechanisms as well as ...

Neighborhood Disadvantage and Neural Correlates of Threat and Reward Processing in Survivors of Recent Trauma (Niels Rathlev) All Scholarly Works (2023)

Importance: Differences in neighborhood socioeconomic characteristics are important considerations in understanding differences in risk vs resilience in mental health. Neighborhood disadvantage is associated with alterations in the function and structure of threat neurocircuitry. Objective: To ...

Derivation and validation of risk prediction for posttraumatic stress symptoms following trauma exposure (Niels Rathlev) All Scholarly Works (2023)

Background: Posttraumatic stress symptoms (PTSS) are common following traumatic stress exposure (TSE). Identification of individuals with PTSS risk in the early aftermath of TSE is important to enable targeted administration of preventive interventions. In this ...

The Association between Emergency Department Length of Stay and In-Hospital Mortality in Older Patients Using Machine Learning: An Observational Cohort Study (Niels Rathlev) All Scholarly Works (2023)

The association between emergency department (ED) length of stay (EDLOS) with in-hospital mortality (IHM) in older patients remains unclear. This retrospective study aims to delineate the relationship between EDLOS and IHM in elderly patients. From ...

Associations of alcohol and cannabis use with change in posttraumatic stress disorder and depression symptoms over time in recently trauma-exposed individuals (Niels Rathlev) All Scholarly Works (2023)

Background: Several hypotheses may explain the association between substance use, posttraumatic stress disorder (PTSD), and depression. However, few studies have utilized a large multisite dataset to understand this complex relationship. Our study assessed the relationship ...

CpG methylation levels in HPA axis genes predict chronic pain outcomes following trauma exposure (Niels Rathlev) All Scholarly Works (2023)

Chronic posttraumatic musculoskeletal pain (CPTP) is a common outcome of traumatic stress exposure. Biological factors that influence the development of CPTP are poorly understood, though current evidence indicates that the hypothalamic-pituitary-adrenal (HPA) axis plays a ...

Internal capsule microstructure mediates the relationship between childhood maltreatment and PTSD following adulthood trauma exposure (Niels Rathlev) All Scholarly Works (2023)

Childhood trauma is a known risk factor for trauma and stress-related disorders in adulthood. However, limited research has investigated the impact of childhood trauma on brain structure linked to later posttraumatic dysfunction. We investigated the ...

Prior Sexual Trauma Exposure Impacts Posttraumatic Dysfunction and Neural Circuitry Following a Recent Traumatic Event in the AURORA Study (Niels Rathlev) All Scholarly Works (2023)

Background: Prior sexual trauma (ST) is associated with greater risk for posttraumatic stress disorder after a subsequent traumatic event; however, the underlying neurobiological mechanisms remain opaque. We investigated longitudinal posttraumatic dysfunction and amygdala functional dynamics ...

Structural inequities contribute to racial/ethnic differences in neurophysiological tone, but not threat reactivity, after trauma exposure (Niels Rathlev) All Scholarly Works (2023)

Considerable racial/ethnic disparities persist in exposure to life stressors and socioeconomic resources that can directly affect threat neurocircuitry, particularly the amygdala, that partially mediates susceptibility to adverse posttraumatic outcomes. Limited work to date, however, has ...

Childhood adversities and risk of posttraumatic stress disorder and major depression following a motor vehicle collision in adulthood (Niels Rathlev) All Scholarly Works (2023)

Aims: Childhood adversities (CAs) predict heightened risks of posttraumatic stress disorder (PTSD) and major depressive episode (MDE) among people exposed to adult traumatic events. Identifying which CAs put individuals at greatest risk for these adverse ...

Use of serial smartphone-based assessments to characterize diverse neuropsychiatric symptom trajectories in a large trauma survivor cohort (Niels Rathlev) All Scholarly Works (2023)

The authors sought to characterize adverse posttraumatic neuropsychiatric sequelae (APNS) symptom trajectories across ten symptom domains (pain, depression, sleep, nightmares, avoidance, re-experiencing, anxiety, hyperarousal, somatic, and mental/fatigue symptoms) in a large, diverse, understudied sample of ...

Utility of Wrist-Wearable Data for Assessing Pain, Sleep, and Anxiety Outcomes After Traumatic Stress Exposure (Niels Rathlev) All Scholarly Works (2023)

Importance: Adverse posttraumatic neuropsychiatric sequelae after traumatic stress exposure are common and have higher incidence among socioeconomically disadvantaged populations. Pain, depression, avoidance of trauma reminders, reexperiencing trauma, anxiety, hyperarousal, sleep disruption, and nightmares have been ...

Length-of-Stay in the Emergency Department and In-Hospital Mortality: A Systematic Review and Meta-Analysis (Niels Rathlev) All Scholarly Works (2022)

The effect of emergency department (ED) length of stay (EDLOS) on in-hospital mortality (IHM) remains unclear. The aim of this systematic review and meta-analysis was to determine the association between EDLOS and IHM. We searched ...

Derivation and Validation of a Brief Emergency Department-Based Prediction Tool for Posttraumatic Stress After Motor Vehicle Collision (Niels Rathlev) All Scholarly Works (2022)

Study objective: To derive and initially validate a brief bedside clinical decision support tool that identifies emergency department patients at high risk of substantial, persistent posttraumatic stress symptoms after a motor vehicle collision. Methods: Derivation ...

Anxiety sensitivity as a transdiagnostic risk factor for trajectories of adverse posttraumatic neuropsychiatric sequelae in the AURORA study (Niels Rathlev) All Scholarly Works (2022)

Anxiety sensitivity, or fear of anxious arousal, is cross-sectionally associated with a wide array of adverse posttraumatic neuropsychiatric sequelae, including symptoms of posttraumatic stress disorder, depression, anxiety, sleep disturbance, pain, and somatization. The current study ...

Predicting at-risk opioid use three months after ed visit for trauma: Results from the AURORA study (Niels Rathlev) All Scholarly Works (2022)

Objective: Whether short-term, low-potency opioid prescriptions for acute pain lead to future at-risk opioid use remains controversial and inadequately characterized. Our objective was to measure the association between emergency department (ED) opioid analgesic exposure after ...

Structural covariance of the ventral visual stream predicts posttraumatic intrusion and nightmare symptoms: a multivariate data fusion analysis (Niels Rathlev) All Scholarly Works (2022)

Visual components of trauma memories are often vividly re-experienced by survivors with deleterious consequences for normal function. Neuroimaging research on trauma has primarily focused on threat-processing circuitry as core to trauma-related dysfunction. Conversely, limited attention ...

Derivation and validation of risk prediction for posttraumatic stress symptoms following trauma exposure (Niels Rathlev) All Scholarly Works (2022)

Background: Posttraumatic stress symptoms (PTSS) are common following traumatic stress exposure (TSE). Identification of individuals with PTSS risk in the early aftermath of TSE is important to enable targeted administration of preventive interventions. In this ...

Hippocampal Threat Reactivity Interacts with Physiological Arousal to Predict PTSD Symptoms (Niels Rathlev) All Scholarly Works (2022)

Hippocampal impairments are reliably associated with post-traumatic stress disorder (PTSD); however, little research has characterized how increased threat-sensitivity may interact with arousal responses to alter hippocampal reactivity, and further how these interactions relate to the ...

From intern to "accepted": A guide to preparing for fellowship in emergency medicine (Niels Rathlev) All Scholarly Works (2022)

Introduction: The number of fellowship options for emergency medicine (EM) physicians continues to expand. While guides exist to help residents explore individual fellowship pathways, we aimed to create a comprehensive guide for all residents considering ...

From intern to “accepted”: A guide to preparing for fellowship in emergency medicine (Niels Rathlev) All Scholarly Works (2022)

From the ground up: Creating and leading fellowship programs in emergency medicine (Niels Rathlev) All Scholarly Works (2022)

Background: A methodical and evidence-based approach to the creation and implementation of fellowship programs is not well described in the graduate medical education literature. The Society for Academic Emergency Medicine (SAEM) convened an expert panel ...

Persistent Dissociation and Its Neural Correlates in Predicting Outcomes After Trauma Exposure (Niels Rathlev) All Scholarly Works (2022)

Objective: Dissociation, a disruption or discontinuity in psychological functioning, is often linked with worse psychiatric symptoms; however, the prognostic value of dissociation after trauma is inconsistent. Determining whether trauma-related dissociation is uniquely predictive of later ...

Corrigendum to "Learning from gain and loss: Links to suicide risk" [J. Psychiatr. Res. 147 (2022) 126-134] (Niels Rathlev) All Scholarly Works (2022)

Prior differences in previous trauma exposure primarily drive the observed racial/ethnic differences in posttrauma depression and anxiety following a recent trauma (Niels Rathlev) All Scholarly Works (2022)

Background: Racial and ethnic groups in the USA differ in the prevalence of posttraumatic stress disorder (PTSD). Recent research however has not observed consistent racial/ethnic differences in posttraumatic stress in the early aftermath of trauma, ...