Pre-existing mental disorder, clinical profile, inpatient services and costs in people hospitalised following traumatic spinal injury: a whole population record linkage study.

burden of disease costs mental health socioeconomic status spinal cord injury trauma systems

Journal

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention
ISSN: 1475-5785
Titre abrégé: Inj Prev
Pays: England
ID NLM: 9510056

Informations de publication

Date de publication:
15 May 2020
Historique:
received: 10 11 2019
revised: 06 02 2020
accepted: 19 04 2020
entrez: 17 5 2020
pubmed: 18 5 2020
medline: 18 5 2020
Statut: aheadofprint

Résumé

Risk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI, the incidence, management and cost of this often complex comorbid health profile is not sufficiently understood. In a whole population cohort of patients hospitalised with acute TSI, we aimed to describe the prevalence of pre-existing mental disorders and compare differences in injury epidemiology, costs and inpatient allied health service access. Record linkage study of all hospitalised cases of TSI between June 2013 and June 2016 in New South Wales, Australia. TSI was defined by specific International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes. Mental disorder status was considered as pre-existing where specific ICD-10-AM codes were recorded in incident admissions. 13 489 individuals sustained acute TSI during this study. 13.11%, 6.06% and 1.82% had pre-existing mental illness, substance use disorder and dual diagnosis, respectively. Individuals with mental disorder were older (p<0.001), more likely to have had a fall or self-harmed (p<0.001), experienced almost twice the length of stay and inpatient complications, and increased injury severity compared with individuals without mental disorder (p<0.001). Individuals hospitalised for TSI with pre-existing mental disorder have greater likelihood of increased injury severity and more complex, costly acute care admissions compared with individuals without mental disorder. Care pathway optimisation including prevention of hospital-acquired complications for people with pre-existing mental disorders hospitalised for TSI is warranted.

Sections du résumé

BACKGROUND BACKGROUND
Risk of traumatic injury is increased in individuals with mental illness, substance use disorder and dual diagnosis (mental disorders); these conditions will pre-exist among individuals hospitalised with acute traumatic spinal injury (TSI). Although early intervention can improve outcomes for people who experience mental disorders or TSI, the incidence, management and cost of this often complex comorbid health profile is not sufficiently understood. In a whole population cohort of patients hospitalised with acute TSI, we aimed to describe the prevalence of pre-existing mental disorders and compare differences in injury epidemiology, costs and inpatient allied health service access.
METHODS METHODS
Record linkage study of all hospitalised cases of TSI between June 2013 and June 2016 in New South Wales, Australia. TSI was defined by specific International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes. Mental disorder status was considered as pre-existing where specific ICD-10-AM codes were recorded in incident admissions.
RESULTS RESULTS
13 489 individuals sustained acute TSI during this study. 13.11%, 6.06% and 1.82% had pre-existing mental illness, substance use disorder and dual diagnosis, respectively. Individuals with mental disorder were older (p<0.001), more likely to have had a fall or self-harmed (p<0.001), experienced almost twice the length of stay and inpatient complications, and increased injury severity compared with individuals without mental disorder (p<0.001).
CONCLUSION CONCLUSIONS
Individuals hospitalised for TSI with pre-existing mental disorder have greater likelihood of increased injury severity and more complex, costly acute care admissions compared with individuals without mental disorder. Care pathway optimisation including prevention of hospital-acquired complications for people with pre-existing mental disorders hospitalised for TSI is warranted.

Identifiants

DOI: 10.1136/injuryprev-2019-043567 PMID: 32414771
pubmed: 32414771
pii: injuryprev-2019-043567
doi: 10.1136/injuryprev-2019-043567
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Auteurs

Lisa Nicole Sharwood (LN)

Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia lisa.sharwood@sydney.edu.au.
Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Faculty of Engineering and Risk, University of Technology Sydney, Sydney, NSW, Australia.
ORCID: 0000-0001-8977-6144

Taneal Wiseman (T)

Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia.

Emma Tseris (E)

Faculty of Arts and Social Sciences, Sydney School of Education and Social work, University of Sydney, Sydney, New South Wales, Australia.

Kate Curtis (K)

Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Health and Medicine, The University of Sydney, Sydney, New South Wales, Australia.
Illawarra Shoalhaven Local Health District, Wollongong Hospital, Wollongong, New South Wales, Australia.
Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.
The George Institute for Global Health, Newtown, New South Wales, Australia.

Bharat Vaikuntam (B)

Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

Ashley Craig (A)

Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

Jesse Young (J)

Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia.
Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, VIC, Australia.
National Drug Research Institute, Curtin University, Perth, WA, Australia.
ORCID: 0000-0001-5702-372X

Classifications MeSH