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Introduction <p>The purpose of this study was to quantify the impact of psychiatric comorbidity on in-hospital costs after multitrauma.</p> Methods <p>A retrospective single-center cohort study identified adult trauma patients with an Injury Severity Score (ISS) ≥ 16, who entered the hospital between January 2018 and December 2019. Descriptive statistics were assessed for patient characteristics, injury characteristics, and injury outcomes. Bivariate analysis was performed for in-hospital costs between patients with and without psychiatric comorbidity. The psychiatric cohort was then further divided into different sub-cohorts by status of their psychiatric comorbidity: ‘Acute’ for patients with no known history of psychiatric illness who required inpatient psychiatric consultation for a newly diagnosed or suspected psychiatric illness, ‘Stable’ for patients with a prior psychiatric history that did not require inpatient psychiatric consultation, and ‘Chronic’ for patients with a prior psychiatric history that required continued inpatient psychiatric consultation. Baseline demographic and in-hospital cost data was compared between these cohorts.</p> Results <p>Of the 616 patients meeting inclusion criteria, 94 patients (15.3%) either suffered from pre-existing psychiatric illness, needed psychiatric consultation during hospitalization, or suffered both pre-existent from a psychiatric illness <i>and</i> needed psychiatric consultation during hospitalization. The psychiatric cohort generated significantly higher total in-hospital costs than the control cohort (median costs: €22.000 versus €15.200, respectively (<i>p</i> &lt; 0.01). In particular, the Acute psychiatric cohort generated the highest hospital expenses (median total in-hospital costs €47.000). Multivariable regression analyses did not reveal psychiatric comorbidity as an independent predictor of higher in-hospital costs (<i>p</i> = 0.88). Instead, the duration of hospital stay (<i>p</i> &lt; 0.01), ISS (<i>p</i> &lt; 0.01), and the number of total surgical interventions (<i>p</i> &lt; 0.01) independently predicted higher total in-hospital costs.</p> Conclusions <p>Although in-hospital costs of multitrauma patients were higher among patients with psychiatric comorbidity, psychiatric comorbidity does not independently predict increased in-hospital costs for patients after multitrauma. Instead, higher in-hospital costs are due to longer inpatient stay, higher ISS and greater number of surgical interventions among those with psychiatric comorbidity.</p>

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Influence of psychiatric comorbidity on in-hospital costs for multitrauma patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月19日

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  • Tijmen D. van den Bosch,
  • Maximilian A. Meyer,
  • Juanita A. Haagsma,
  • Marilyn Heng,
  • Loek P. H. Leenen,
  • Falco Hietbrink,
  • R. Marijn Houwert,
  • Marjan Kromkamp,
  • Stijn D. Nelen

摘要

Introduction

The purpose of this study was to quantify the impact of psychiatric comorbidity on in-hospital costs after multitrauma.

Methods

A retrospective single-center cohort study identified adult trauma patients with an Injury Severity Score (ISS) ≥ 16, who entered the hospital between January 2018 and December 2019. Descriptive statistics were assessed for patient characteristics, injury characteristics, and injury outcomes. Bivariate analysis was performed for in-hospital costs between patients with and without psychiatric comorbidity. The psychiatric cohort was then further divided into different sub-cohorts by status of their psychiatric comorbidity: ‘Acute’ for patients with no known history of psychiatric illness who required inpatient psychiatric consultation for a newly diagnosed or suspected psychiatric illness, ‘Stable’ for patients with a prior psychiatric history that did not require inpatient psychiatric consultation, and ‘Chronic’ for patients with a prior psychiatric history that required continued inpatient psychiatric consultation. Baseline demographic and in-hospital cost data was compared between these cohorts.

Results

Of the 616 patients meeting inclusion criteria, 94 patients (15.3%) either suffered from pre-existing psychiatric illness, needed psychiatric consultation during hospitalization, or suffered both pre-existent from a psychiatric illness and needed psychiatric consultation during hospitalization. The psychiatric cohort generated significantly higher total in-hospital costs than the control cohort (median costs: €22.000 versus €15.200, respectively (p < 0.01). In particular, the Acute psychiatric cohort generated the highest hospital expenses (median total in-hospital costs €47.000). Multivariable regression analyses did not reveal psychiatric comorbidity as an independent predictor of higher in-hospital costs (p = 0.88). Instead, the duration of hospital stay (p < 0.01), ISS (p < 0.01), and the number of total surgical interventions (p < 0.01) independently predicted higher total in-hospital costs.

Conclusions

Although in-hospital costs of multitrauma patients were higher among patients with psychiatric comorbidity, psychiatric comorbidity does not independently predict increased in-hospital costs for patients after multitrauma. Instead, higher in-hospital costs are due to longer inpatient stay, higher ISS and greater number of surgical interventions among those with psychiatric comorbidity.