Outcomes in Trauma Patients With Behavioral Health Disorders

The Impact of Socially Stigmatized Preexisting Conditions on Outcomes After Injury

“…The finding of higher complication but lower mortality rate observed is consistent with other studies looking at comorbidity burdens of preexisting conditions similar to those in our study and their association with patient outcomes. 1,2 In contrast, other literature that has studied the effects of different, more physiological preexisting comorbidities, such as diabetes, congestive heart failure, or myocardial infarction, on patient outcomes found a higher mortality risk, an outcome different from our study. 23 The existing literature has shown both similar and different complications.…”

“…Patients with behavioral health disorders had the four most common complications, including unplanned takeback to the operating room, unplanned transfer to the ICU, unplanned intubation, and ventilatorassociated pneumonia. 1 There are parallels with the complications found in our study among SSPEC patients, including unplanned intubation (2.2%) and unplanned return to the ICU (2.3%).…”

“…Socially stigmatized preexisting conditions (SSPECs), including alcohol use disorder (AUD), drug use disorder (DUD), and major psychiatric illness, may lead to provider minimization of patient symptoms and have been associated with increased complications in orthopedic and general trauma patient populations. 1,2 Stigmatizing practices by health care providers and their detrimental impacts on patient care and outcomes has been widely documented in our study population, 3,4 as well as in other patient populations, 5 including patients with tuberculosis, 6 lung cancer, 7 and HIV. 8 The manifestations of these stigmas also cover a wide range, from completely denying care to passing of patients to junior colleagues or making certain patients wait a longer period before being seen.…”

Epidemiology of trauma in patients with mental disorders

“… 9 11 The longer LOS among the psychiatric cohort has been attributed to increased social needs and delays in consultation time. 11 15 However, given that these variables were not assessed in our study, their potential impact on our findings remains speculative.…”

“…Psychiatric illnesses have a significant impact on the clinical outcomes of patients, as they have been associated with increased morbidity, lower quality of healthcare, and worse health 4–10. Moreover, individuals with mental disorders are at greater risk of unintentional injuries when compared with the general population 4 11–13. Previous analyses have suggested that trauma patients with psychiatric disorders are more likely to suffer unintentional and self-inflicted injuries relative to those without these comorbid conditions 8 9 11 12 14.…”