Patients with recognized psychiatric disorders in trauma surgery: incidence, inpatient length of stay, and cost.
BACKGROUND
Although psychiatric disturbances are highly prevalent among traumatically injured inpatients, few investigations have assessed the impact of these disorders on surgical length of stay (LOS) and cost.


METHODS
The authors identified all trauma-registry recorded psychiatric diagnoses among patients admitted to University of California Davis Medical Center between January 1993 and December 1996. Linear and logistic regressions were used to assess the unique effects of psychiatric diagnoses on inpatient LOS and cost.


RESULTS
A total of 29% of patients had one or more registry-recorded psychiatric diagnosis. Patients with alcohol abuse diagnoses demonstrated 10% to 12% decreases in LOS and cost (p < 0.01), whereas patients with stress disorders, delirium, and psychoses demonstrated 46% to 103% increases in LOS and cost (p < 0.01).


CONCLUSIONS
Patients with recognized psychiatric disorders uniquely impact inpatient trauma surgery LOS and cost. Additional investigations of the processes and outcomes of care could lead to cost-effective performance improvement efforts that target the amelioration of comorbid psychiatric disorders among physically injured trauma survivors.
Zatzick
D F
DF
Department of Psychiatry, University of California at Davis, Sacramento, USA.
Kang
S M
SM
Kim
S Y
SY
Leigh
P
P
Kravitz
R
R
Drake
C
C
Sue
S
S
Wisner
D
D
D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D017721:Hospital Costs; D006785:Hospitals, University / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D001523:Mental Disorders / Q000150:complications / Q000191:economics* / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000191:economics / Q000453:epidemiology; D014193:Trauma Centers / Q000191:economics / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000150:complications / Q000191:economics* / Q000453:epidemiology*