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Objective: Studies that describe the characteristics of injuries in patients with multiple pre-existing mental altering comorbidities are limited. Therefore, the main objective of this research is to study a full spectrum of the patterns of traumatic injuries in patients who were pre-disposed to have mental alteration as a result of selected pre-existing co-morbidities.

Materials and Methods: This is a retrospective study of trauma patients ≥10 years old based on the data from the NTDB. Patients with the diagnosis of pre-existing mental altering co-morbidities were identified using ICD-10 diagnosis codes. Descriptive and multivariate logistic regression analyses were employed using demographic variables and injury characteristics to identify the associations between MOI, PMAC and the intents of injuries in the patients who visited the trauma centers of participating hospitals in the United States.

Results: A total of 1,032,919 patients with the diagnosis of traumatic injuries age between 10 to 89 years old were analyzed. Of this number 200,700(17.6%) were patients with PMAC (targets) and the rest 832,219(73.0%) were patients without documented PMAC (controls), Male=677,943(59.43%) and female=462,570(40.55%). The average age of all injured patients was 47 (SD± 24.66) years old. Overall more geriatric female patients [19,628(9.780%)] with PMAC (age 80-89) suffered from traumatic injuries mainly fall (69.0%) and this was prominent in white (Not Latino) racial group. Self-harm was more prevalent in male target patients (31%). Major psychiatric illness was slightly more prevalent in female targets (20.02%) while substance use disorders in male targets (drug=18.78%, alcohol=14.21%), more than three times higher than the females. There were more common statistically significant (P<0.001) MOI (W01.0XXA the most common) that caused injuries in the target patients. Female patients with substance use disorder (alcohol) major psychiatric illness and CVA had a more predicted probability for fall injury of W01.0XXA (P<0.0001 for all). Male target patients with drug use disorder had the highest probability of getting an assault injury (X93.XXXA) followed by male patients with alcohol use disorder and female patients with drug use disorder. Self-inflicted intents were more prevalent (3.7%) in the target patients and the comparison of the proportion to controls was statistically significant (p<0.0001).

Conclusion: Over all female target patients were found to have higher predicted probabilities for fall and exposure, transport accidents, and assault injuries. But we still need more structured prospective studies to be done to substantiate this finding. The fact that traumatic injuries were more prevalent in female older target patients will remain an important point of future investigation.

ETD_10506

Ph.D.

Includes bibliographical references

doi:10.7282/t3-fq68-fc42

ETD doctoral

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