Patients with recognized psychiatric disorders in trauma surgery: Incidence, inpatient length of stay, and cost

Background: Although psychiatric disturbances are highly prevalent among tr aumatically 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 di agnoses among patients admitted to University of California Davis Medical C enter between January 1993 and December 1996, Linear and logistic regressio ns were used to assess the unique effects of psychiatric diagnoses on inpat ient LOS and cost. Results: A total of 29% of patients had one or more registry-recorded psych iatric diagnosis. Patients with alcohol abuse diagnoses demonstrated 10% to 12% decreases in LOS and cost (p < 0.01), whereas patients with stress dis orders, delirium, and psychoses demonstrated 46% to 103% increases in LOS a nd cost (p < 0.01). Conclusion: Patients with recognized psychiatric disorders uniquely impact inpatient trauma surgery LOS and cost. Additional investigations of the pro cesses and outcomes of care could lead to cost-effective performance improv ement efforts that target the amelioration of comorbid psychiatric disorder s among physically injured trauma survivors.