Warnack Elizabeth, Choi Beatrix Hyemin, DiMaggio Charles, Frangos Spiros, Bukur Marko, Marshall Gary
Am Surg. 2018 Dec 1;84(12):1889-1893.
The objective of this study was to assess whether patients with comorbid psychiatric conditions admitted after traumatic injury require greater health-care resource utilization. The trauma registry of a Level 1 trauma center was used to identify all adult trauma patients presenting from 2012 to 2015. Patients with psychiatric needs, identified as having either an ICD-9 code corresponding to a psychiatric disorder or requiring inpatient psychiatric consultation, were compared with controls, using propensity score matching. Patients with psychiatric disorders were more than three times more likely to present with penetrating injuries (odds ratio [OR] 3.5, < 0.005). They had longer length of hospital stay (median 5 [IQR 2.5-11] three days [IQR 1-7], 0.01), were approximately 70 per cent more likely to require ICU-level care (OR 1.68, = 0.08), and were 80 per cent less likely to be discharged home (OR 0.18, < 0.005). Trauma patients with psychiatric illness or need consume greater health-care resources.
本研究的目的是评估创伤后入院的合并精神疾病患者是否需要更多的医疗资源利用。利用一级创伤中心的创伤登记系统，识别出2012年至2015年期间所有成年创伤患者。通过倾向得分匹配，将有精神疾病需求的患者（被识别为具有与精神疾病对应的ICD-9编码或需要住院精神科会诊）与对照组进行比较。患有精神疾病的患者出现穿透性损伤的可能性高出三倍多（比值比[OR] 3.5，<0.005）。他们的住院时间更长（中位数5天[四分位间距2.5 - 11天]对比3天[四分位间距1 - 7天]，<0.01），需要重症监护病房（ICU）级别护理的可能性高出约70%（OR 1.68，=0.08），而回家出院的可能性低80%（OR 0.18，<0.005）。患有精神疾病或有精神疾病需求的创伤患者消耗更多的医疗资源。
