Townsend Laura L, Esquivel Micaela M, Uribe-Leitz Tarsicio, Weiser Thomas G, Maggio Paul M, Spain David A, Tennakoon Lakshika, Staudenmayer Kristan
Vassar College, Poughkeepsie, New York.
Department of Surgery, Stanford University, Stanford, California.
J Surg Res. 2017 Jun 1;213:171-176. doi: 10.1016/j.jss.2017.02.014. Epub 2017 Feb 23.
We hypothesized that psychiatric diagnoses would be common in hospitalized trauma patients in the United States and when present, would be associated with worse outcomes.
The Nationwide Inpatient Sample (NIS, 2012) was used to determine national estimates for the number of patients admitted with an injury. Psychiatric diagnoses were identified using diagnosis codes according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.
A total of 36.5 million patients were admitted to hospitals in the United States in 2012. Of these, 1.3 million (4%) were due to trauma. Psychiatric conditions were more common in patients admitted for trauma versus those admitted for other reasons (44% versus 34%, P < 0.001). Trauma patients who had a psychiatric diagnosis compared to trauma patients without a psychiatric diagnosis were older (mean age: 61 versus 56 y, P < 0.001), more often female (52% versus 50%, P < 0.001), and more often white (73% versus 68%, P < 0.001). For ages 18-64, drug and alcohol abuse predominated (41%), whereas dementia and related disorders (48%) were the most common in adults ≥65 y. Mortality was lower for trauma patients with a psychiatric diagnosis compared to those who did not in both unadjusted and adjusted analysis (1.9% versus 2.8%; odds ratio: 0.56, P < 0.001).
Psychiatric conditions are present in almost half of all hospitalized trauma patients in the United States; however, the types of conditions varied with age. The frequency of psychiatric conditions in the trauma population suggests efforts should be made to address this component of patient health.
我们推测精神疾病诊断在美国住院创伤患者中很常见，并且一旦存在，会与更差的预后相关。
使用全国住院患者样本（2012年NIS）来确定全国范围内因伤入院患者的数量。根据《精神疾病诊断与统计手册》第五版，使用诊断编码来识别精神疾病诊断。
2012年美国共有3650万患者入院。其中，130万（4%）是因创伤入院。与因其他原因入院的患者相比，因创伤入院的患者中精神疾病更为常见（44%对34%，P<0.001）。与没有精神疾病诊断的创伤患者相比，有精神疾病诊断的创伤患者年龄更大（平均年龄：61岁对56岁，P<0.001），女性更多（52%对50%，P<0.001），白人更多（73%对68%，P<0.001）。在18 - 64岁人群中，药物和酒精滥用占主导（41%），而在≥65岁成年人中，痴呆及相关障碍最常见（48%）。在未调整和调整分析中，有精神疾病诊断的创伤患者死亡率均低于无精神疾病诊断的患者（1.9%对2.8%；优势比：0.56，P<0.001）。
在美国，几乎一半的住院创伤患者存在精神疾病；然而，疾病类型随年龄而异。创伤人群中精神疾病的发生率表明应努力解决患者健康的这一组成部分。
