TY - JOUR
T1 - Psychological health status after major trauma across different levels of trauma care
T2 - A multicentre secondary analysis
AU - Van Ditshuizen, J. C.
AU - De Jongh, M. A.C.
AU - BIOS-group
AU - Hartog, D. Den
AU - Lansink, K. W.W.
AU - Verhofstad, M. H.J.
AU - Van Lieshout, E. M.M.
AU - van der Veen, A. H.
AU - Stevens, C. T.
AU - Vos, D. I.
AU - van Eijck, F. C.
AU - van Geffen, H. J.A.A.
AU - van Eerten, P. V.
AU - Haagh, W. A.J.J.M.
AU - Sintenie, J. B.
AU - Poelhekke, L. M.S.J.
AU - Soesman, N. M.R.
AU - Jakma, T. S.C.
AU - Waleboer, M.
AU - Staarink, M.
AU - Bruijninckx, M. M.M.
AU - Cardon, A. Y.M.V.P.
AU - den Hoed, P. T.
AU - Vermeulen, J.
AU - van der Vlies, C. H.
AU - Schep, N. W.L.
AU - van de Schoot, L.
N1 - Publisher Copyright:
© 2025 The Author(s)
PY - 2025/2
Y1 - 2025/2
N2 - Introduction: Concentration of trauma care in trauma network has resulted in different trauma populations across designated levels of trauma care. Objective: Describing psychological health status, by means of the impact event scale (IES) and the hospital anxiety and depression scale (HADS), of major trauma patients one and two years post-trauma across different levels of trauma care in trauma networks. Methods: A multicentre retrospective cohort study was conducted. Inclusion criteria: aged ≥ 18 and an Injury Severity Score (ISS) > 15, surviving their injuries one year after trauma. Psychological health status was self-reported with HADS and IES. Subgroup analysis, univariate, and multivariable analysis were done on level of trauma care and trauma region for HADS and IES as outcome measures. Results: Psychological health issues were frequently reported (likely depressed n = 31, 14.7 %); likely anxious n = 32, 15.2 %; indication of a post-traumatic stress disorder n = 46, 18.0 %). Respondents admitted to a level I trauma centre reported more symptoms of anxiety (3, P25-P75 1–6 vs. 5, P25-P75 2–9, p = 0.002), depression (2, P25-P75 1–5 vs. 5, P25-P75 2–9, p < 0.001), and post-traumatic stress (6, P25-P75 0–15 vs. 13, P25-P75 3–33, p = 0.001), than patients admitted to a non-level I trauma centre. Differences across trauma regions were reported for depression (3, P25-P75 1–6 vs. 4, P25-P75 2–10, p = 0.030) and post-traumatic stress (7, P25-P75 0–18 vs. 15, P25-P75 4–34, p < 0.001). Conclusions: Major trauma patients admitted to a level I trauma centre have more depressive, anxious, and post-traumatic stress symptoms than when admitted to a non-level I trauma centre. These symptoms differed across trauma regions, indicating populations differences. Level of trauma care and trauma region are important when analysing psychological health status.
AB - Introduction: Concentration of trauma care in trauma network has resulted in different trauma populations across designated levels of trauma care. Objective: Describing psychological health status, by means of the impact event scale (IES) and the hospital anxiety and depression scale (HADS), of major trauma patients one and two years post-trauma across different levels of trauma care in trauma networks. Methods: A multicentre retrospective cohort study was conducted. Inclusion criteria: aged ≥ 18 and an Injury Severity Score (ISS) > 15, surviving their injuries one year after trauma. Psychological health status was self-reported with HADS and IES. Subgroup analysis, univariate, and multivariable analysis were done on level of trauma care and trauma region for HADS and IES as outcome measures. Results: Psychological health issues were frequently reported (likely depressed n = 31, 14.7 %); likely anxious n = 32, 15.2 %; indication of a post-traumatic stress disorder n = 46, 18.0 %). Respondents admitted to a level I trauma centre reported more symptoms of anxiety (3, P25-P75 1–6 vs. 5, P25-P75 2–9, p = 0.002), depression (2, P25-P75 1–5 vs. 5, P25-P75 2–9, p < 0.001), and post-traumatic stress (6, P25-P75 0–15 vs. 13, P25-P75 3–33, p = 0.001), than patients admitted to a non-level I trauma centre. Differences across trauma regions were reported for depression (3, P25-P75 1–6 vs. 4, P25-P75 2–10, p = 0.030) and post-traumatic stress (7, P25-P75 0–18 vs. 15, P25-P75 4–34, p < 0.001). Conclusions: Major trauma patients admitted to a level I trauma centre have more depressive, anxious, and post-traumatic stress symptoms than when admitted to a non-level I trauma centre. These symptoms differed across trauma regions, indicating populations differences. Level of trauma care and trauma region are important when analysing psychological health status.
UR - http://www.scopus.com/inward/record.url?scp=85215134646&partnerID=8YFLogxK
U2 - 10.1016/j.injury.2025.112152
DO - 10.1016/j.injury.2025.112152
M3 - Article
C2 - 39827530
AN - SCOPUS:85215134646
SN - 0020-1383
VL - 56
JO - Injury
JF - Injury
IS - 2
M1 - 112152
ER -