Evidence map›Paper›PMID 39800884›Full record

ArticleThe journal of trauma and acute care surgery2025

Association of pre- and postinjury mental health with long-term clinical and financial outcomes.

Patrick L Johnson, Mark R Hemmila, Cody L Mullens, Bryant W Oliphant, Janessa R Monahan, Julia D Kelm, Jill L Jakubus, William J Curtiss, Benjamin D Mosher, Alicia N Kieninger and 1 more

Abstract readMulticenter Study
In one paragraph

Article in The journal of trauma and acute care surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Patrick L JohnsonFrom the Department of Surgery (P.L.J., M.R.H., C.L.M., J.R.M., J.D.K., J.L.J.), University of Michigan Medical School; Center for Healthcare Outcomes and Policy (P.L.J., M.R.H., C.L.M., B.W.O., J.W.S.) and Department of Orthopedic Surgery (B.W.O.), University of Michigan Medical School; Department of Surgery (W.J.C.), Trinity Health Ann Arbor Hospital, Ann Arbor; Department of Surgery (B.D.M.), University of Michigan Health-Sparrow, Lansing; Department of Surgery (A.N.K.), Trinity Health Oakland Campus, Pontiac, Michigan; and Department of Surgery (J.W.S.), University of Washington, Harborview Medical Center, Seattle, Washington.ORCID 0009-0006-9678-5237
Mark R Hemmila
Cody L Mullens
Bryant W Oliphant
Janessa R Monahan
Julia D Kelm
Jill L Jakubus
William J Curtiss
Benjamin D Mosher
Alicia N Kieninger
John W Scott

Funding

AHRQ HHS K08 HS028672
6 · The paper itself

Abstract

backgroundAs increased attention is placed on optimizing long-term outcomes of trauma patients by addressing mental health, little is known regarding the interplay of pre- and postinjury mental health on long-term financial and functional outcomes.

methodsPatients from 19 Level 1 and 2 trauma centers took part in serial surveys 1 to 24 months postdischarge. Preinjury mental health diagnoses were identified using trauma registry data and postinjury mental health symptoms from survey data. Outcomes included (1) health-related quality of life from the EuroQol-5D-5L and (2) elements of financial toxicity (e.g. medical debt, job/income loss, nonmedical bills, unaffordable care). Multivariable models were created, adjusting for patient, injury, and treatment factors, to evaluate the association of preinjury mental health diagnoses and postinjury mental health symptoms on health-related quality of life and financial toxicity.

resultsA total of 1,017 patients completed 1,297 surveys from July 2021 to December 2023, at a median of 6 months postinjury. Forty-six percent were female, the median age was 67.5 years, and 89% had blunt injuries. Thirty-two percent of patients had a preinjury mental health diagnosis, and 49% had self-reported mental health symptoms postdischarge. Patients with preinjury mental health diagnoses had higher odds of postinjury mental health symptoms (adjusted odds ratio, 3.6 [2.6-4.9]; p < 0.001); however, 55% of those with postinjury symptoms had no preinjury diagnosis. Postinjury symptoms alone were associated with worse health-related quality of life or financial toxicity. Notably, patients with new postinjury mental health symptoms (no preinjury mental health diagnosis) had the highest rate of foregone postinjury care because of costs (26% vs. 14%, p < 0.01).

conclusionMore than one-in-two patients had peri-injury mental health conditions, and patients with postinjury mental health symptoms experienced worse financial and functional outcomes. Addressing postinjury mental health may potentially improve long-term health-related quality of life of trauma survivors; however, efforts are needed to ensure that patients can afford the care needed for optimal health. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level IV.

Indexed as

Mental DisordersMental HealthQuality of LifeWounds and InjuriesAdultAgedFemaleHumansMaleMiddle AgedRegistriesSurveys and QuestionnairesTrauma Centers

Identifiers

PMID39800884
PMCPMC13218826

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.