Post-injury Outcomes of Children with Behavioral Health Disorders

Abstract Background The impact of Behavioral Health Disorders (BHDs) on pediatric injury is poorly understood. We investigated the relationship between BHDs and outcomes following pediatric trauma. Methods We analyzed injured children (age 5-15) from 2014-2016 using the Pediatric Trauma Quality Improvement Program. The primary outcome was in-hospital mortality. Univariable and multivariable analyses compared children with and without a comorbid BHD. Results Of 69,305 injured children, 3,448 (5%) had a BHD. These 3,448 children had a median of 1 [IQR: 1, 1] BHD diagnosis: ADHD (n=2491), major psychiatric disorder (n=1037), drug use disorder (n=250), and alcohol use disorder (n=29). A higher proportion of injured children with BHDs suffered intentional and penetrating injury. Firearm injuries were more common for BHD patients (3% vs 1%, p 25 compared to children without (5% vs 3%, p 1 , 3 ] vs 2 [ 1 , 4 ], p Conclusion Children with BHDs experienced lower in-hospital mortality risk after traumatic injury despite more severe injury upon presentation. Intentional and penetrating injuries are particularly concerning, and future work should assess prevention efforts in this vulnerable group.