Age-Specific Outcomes in Trauma Patients With Psychiatric Comorbidities: From Childhood to Adulthood

Psychiatric comorbidities are associated with adverse trauma outcomes, yet their impact during the transition from adolescence to adulthood is unclear. This study evaluates the association of psychiatric comorbidities on trauma outcomes in patients aged 15-35 y.

We analyzed data from the American College of Surgeons Trauma Quality Improvement Program for 2017-2022. Patients aged 15-35 with traumatic injuries were included. The primary variable was the presence of psychiatric comorbidities, with age categorized into three groups: 15-18 y, 19-25 y, and 26-35 y. Outcomes included in-hospital complications, length of stay, intensive care unit admission, and ventilator days. Logistic and Poisson regression models assessed the associations of psychiatric comorbidities with outcomes across age groups.

We analyzed data from 1,119,186 patients, of whom 21% had psychiatric comorbidities. In the youngest age group, psychiatric comorbidities were associated with higher of in-hospital complications (odds ratio: 1.25; 95% confidence interval [CI]: 1.16-1.35), longer hospital stay (incidence rate ratio: 1.16; 95% CI: 1.15-1.16), higher need for intensive care unit admission (odds ratio: 1.17; 95% CI: 1.12-1.21), and more days on ventilator support (incidence rate ratio: 1.19; 95% CI: 1.17-1.21). These associations were stronger among older patients, especially those aged 26-35 y.

Psychiatric comorbidities are associated with worse trauma outcomes, with stronger associations observed in older patients. Targeted interventions addressing psychiatric conditions may improve trauma outcomes in adolescent and young adult populations.