@article{ref1,
title="Post-injury outcomes of children with behavioral health disorders",
journal="Journal of pediatric surgery",
year="2021",
author="Traynor, Michael D. Jr and Watkins, Ryan D. and Zielinski, Martin D. and Potter, D. Dean Jr and Moir, Christopher R. and Ishitani, Michael B. and Klinkner, Denise B.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: The impact of Behavioral Health Disorders (BHDs) on pediatric injury is poorly understood. We investigated the relationship between BHDs and outcomes following pediatric trauma. <br><br>METHODS: We analyzed injured children (age 5-15) from 2014 to 2016 using the Pediatric Trauma Quality Improvement Program. The primary outcome was in-hospital mortality. Univariable and multivariable analyses compared children with and without a comorbid BHD. <br><br>RESULTS: Of 69,305 injured children, 3,448 (5%) had a BHD. These 3,448 children had a median of 1 [IQR: 1, 1] BHD diagnosis: ADHD (n = 2491), major psychiatric disorder (n = 1037), drug use disorder (n = 250), and alcohol use disorder (n = 29). A higher proportion of injured children with BHDs suffered intentional and penetrating injury. Firearm injuries were more common for BHD patients (3% vs 1%, p<0.001). Children with BHDs were more likely to have an ISS>25 compared to children without (5% vs 3%, p<0.001). While median LOS was longer for BHD patients (2 [1, 3] vs 2 [1, 4], p<0.001), mortality was similar (1% vs 1%, p = 0.76) and complications were less frequent (7% vs 8%, p = 0.002). BHD was associated with lower risk of mortality (OR 0.45, 95%CI [0.30, 0.69]) after controlling for age, sex, race, trauma type, and injury intent and severity. <br><br>CONCLUSION: Children with BHDs experienced lower in-hospital mortality risk after traumatic injury despite more severe injury upon presentation. Intentional and penetrating injuries are particularly concerning, and future work should assess prevention efforts in this vulnerable group.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2021.04.008",
url="http://dx.doi.org/10.1016/j.jpedsurg.2021.04.008"
}