Mental Health Disorders and Drug Use Increase Hospital Readmission after Traumatic Injury

Introduction: Hospital readmission after traumatic injury is frequent and potentially preventable. Efforts are underway to identify and treat preventable causes of readmission and have often focused on physical ailments. Our study aimed to evaluate how substance use and mental health disorders affect the risk of hospital readmission after trauma. Methods: A retrospective study of adult trauma admissions from June 1, 2015, to December 31, 2021 at an academic Level 1 trauma center was conducted. Patient demographics, alcohol use, polysubstance drug use, and mental health disorders were assessed. Rates of readmission were evaluated with a negative binomial log regression adjusted by time from first trauma admission to end of study. Results: 10,710 trauma patients were included with a mean age of 48.4, with a standard deviation of 23.7, and 64.6% (n = 6,919) were males. 16.4% (n = 1,761) screened positive for alcohol use, 22.6% (2,419) for polysubstance drug use, 12.1% (n = 1,294) for any mental health disorder, respectively. Multivariate analysis showed a significant positive association with hospital readmission for patients with polysubstance drug use (p>0.001; Rate Ratio (RR)=1.48; 95%CI=1.36-1.62) and mental health disorders (p>0.001; RR=2.38; 95%CI=2.16-2.62), but hospital readmission were not associated with alcohol use (p = 0.29; RR=1.06; 95%CI .95-1.17). Conclusion: Polysubstance drug use and presence of mental health disorders are associated with elevated rates of hospital readmission by 48% and 138%, respectively. Appropriate allocation of resources before discharge is important to support these patients and may address these high hospital readmission rates.