Early identification of PTSD in gunshot wound survivors can guide mental health interventions.

• Higher shock index increased PTSD risk (odds ratio, 1.2).
• Hypotension was significantly associated with a positive PTSD diagnosis (odds ratio, 4.0).
• Transfusing more blood products linked to lower PTSD risk (odds ratio, 0.9).

These findings underscore the importance of monitoring physiological markers to better allocate mental health resources for at-risk surgical patients.