Pay Attention to Psychiatric Illness in Polytrauma Patients
Ample research has revealed that a patient’s psychological status influences the outcomes of many medical interventions. While orthopaedists treating patients with multiple-system orthopaedic trauma might not think first of the patient’s mental health, they should definitely take it into account, according to a prognostic study by Weinberg et al. in the March 2, 2016 Journal of Bone & Joint Surgery.
The study found that depression was an independent predictor of increased complications among 130 polytrauma patients who had preexisting psychiatric disorders. The authors also found that, relative to patients managed by a general trauma surgery service, those managed by an orthopaedic surgery service were less likely to receive their home psychiatric medications while hospitalized and were less likely to receive instructions for mental-health follow-up upon discharge. The findings prompt the authors to encourage “awareness of [psychiatric] comorbidities during the treatment of orthopaedic conditions, the involvement of mental health-care providers in care, and the arrangement for meaningful mental health follow-up at the time of discharge.”
In her commentary on the Weinberg et al. study, Margaret McQueen, MD not only concurs with the authors’ admonitions, but adds that “we should control for psychiatric distress in our outcome measures to define the effect of surgical treatment more accurately.”