A Retrospective Evaluation of Psychiatric Recommendations Using the Injured Trauma Survivor Screen

Abstract

Background

Trauma patients are at high risk of developing psychiatric disorders such as Post-Traumatic Stress Disorder (PTSD) and depression. The Injured Trauma Survivor Screen (ITSS) is a validated tool designed to identify trauma patients at risk, facilitating early psychiatric intervention. However, there is limited information on the types of psychiatric recommendations given following positive screenings. This study compares the frequency of positive ITSS and treatment recommendations between blunt and penetrating trauma at a Level 1 urban center.

Methods

We conducted a retrospective chart review of trauma patients (n = 727) screened with the ITSS between August 2023-July 2024. Data was extracted including demographics, trauma mechanism, ITSS screen result (positive/negative), positive result (PTSD, depression, or both), personal psychiatric history, and psychiatric recommendations following positive screenings (psychotherapy, medications, inpatient psychiatric transfer, or no intervention) Descriptive statistics were used to analyze the frequency of each recommendation and compare blunt and penetrating mechanisms.

Results

Of the 727 patients screened, 46% screened positive for either PTSD or depression. Among those who screened positive, 65% were seen by psychiatry. The most common recommendations were psychotherapy (64%) and pharmacotherapy (50%). Penetrating trauma had more positive screens (69%), but no difference in psychiatry consultations or recommendations.

Discussion

This study highlights the current practices in psychiatric recommendations for trauma survivors and underscores the importance of early identification using tools like ITSS. Patients with penetrating trauma or those screening positive for PTSD may represent a unique subset that has specific needs for follow-up.