Evaluation of New Mental Health Diagnoses After Pediatric Traumatic Injuries at a Level 1 Pediatric Trauma Center.

Abstract

Background: Traumatic injury is associated with significant mental health morbidity. To evaluate the need for implementation of active-post injury mental health screening at a Level 1 Pediatric Trauma center, we aimed to characterize all new mental health diagnoses after injury and evaluated for patient or injury factors that may aid in targeting of future screening.

Methods: A single-center retrospective analysis of trauma patients aged 6-18 years presenting in 2022 was performed. Our primary outcome was a new DSM-5 mental health diagnosis documented after traumatic injury. Patients with and without a new mental health diagnosis were compared by age, sex, race, ethnicity, injury type/mechanism, injury severity score (ISS), intensive care unit (ICU) admission, and length of stay (LOS).

Results: 492 patients were included. Their median (IQR) age was 13.5 (10.4, 15.4) years. The median (IQR) follow-up interval was 157 (9, 429) days. There were 24 (4.9%) children with a new mental health diagnosis: 12 (50%) with trauma-related stress disorders, with the remaining having diagnoses such as depressive or anxiety disorders. Patients with a new mental health diagnosis had longer LOS (3.0 [1.8, 7.5] vs 2.0 [1.0, 3.3] days, P = 0.02) and were more likely to have sustained penetrating injury (P = 0.01). There were no differences in demographics, rates of preexisting mental health diagnosis or area deprivation index (P > 0.05).

Discussion: There were fewer new mental health diagnoses in our cohort than expected, likely underestimating the acute need. Comprehensive post-injury screening is imperative to sufficiently identify and intervene upon mental health morbidity after pediatric trauma.