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European Journal of Trauma and Emergency Surgery

Erschienen in:

11.09.2023 | Original Article

Psychiatric comorbidity and trauma: impact on inpatient outcomes and implications for future management

verfasst von: Maximilian Arthur Meyer, Tijmen van den Bosch, Zita Millenaar, Marilyn Heng, Loek Leenen, Falco Hietbrink, Roderick Marijn Houwert, Marjan Kromkamp, Stijn Diederik Nelen

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 2/2024

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Abstract

Purpose

This study aimed to quantify the impact of pre-existing psychiatric illness on inpatient outcomes after major trauma and to assess acuity of psychiatric presentation as a predictor of outcomes.

Methods

A retrospective single-center cohort study identified adult trauma patients with an Injury Severity Score (ISS) ≥ 16 between January 2018 and December 2019. Bivariate analysis assessed patient characteristics, injury characteristics, and injury outcomes between patients with and without psychiatric comorbidity. A sub-group analysis explored further effects of psychiatric history and need for inpatient psychiatric consultation on outcomes.

Results

Of 640 patients meeting inclusion criteria, 99 patients (15.4%) had at least one psychiatric comorbidity. Patients with psychiatric comorbidity sustained distinct mechanisms of injury and higher in-hospital morbidity (44% vs. 26%, OR 1.97, 95% CI 1.17–3.3, p = 0.01), including pulmonary morbidity (31% vs. 21%, p < 0.01), neurologic morbidity (18% vs 7%, p < 0.01), and deep wound infection (8% vs. 2%, p < 0.01) than the control cohort. Psychiatric patients also had significantly greater median intensive care unit (ICU), length of stay (LOS) (1 day vs. 0 days, p = 0.04), median inpatient ward LOS (10 days vs. 7 days, p = 0.02), and median overall hospital LOS (16 days vs. 11 days, p < 0.01). In sub-group analysis, patients with a history of psychiatric illness alone had comparable outcomes to the control group.

Conclusions

Psychiatric comorbidity negatively impacts inpatient morbidity and inpatient LOS. This effect is most pronounced among acute psychiatric episodes with or without a history of mental illness.

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Titel: Psychiatric comorbidity and trauma: impact on inpatient outcomes and implications for future management
verfasst von: Maximilian Arthur Meyer
Tijmen van den Bosch
Zita Millenaar
Marilyn Heng
Loek Leenen
Falco Hietbrink
Roderick Marijn Houwert
Marjan Kromkamp
Stijn Diederik Nelen
Publikationsdatum: 11.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 2/2024
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-023-02359-w

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Psychiatric comorbidity and trauma: impact on inpatient outcomes and implications for future management