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Research Snapshot Theater: Trauma, Adult II

Bipolar Disorders and Resource Utilization in ICU Trauma Surgery: A Population-Based Cohort Study

Tuesday, March 24, 2026
10:00 AM - 11:00 AM Central Time
Location: Connections Central - RST 17
Introduction: Mental disorders such as bipolar disorder (BD) are recognized as important in trauma outcomes. BD is linked to impulsivity and high-risk behaviors, increasing injury risk. Prior studies found BD associated with more trauma occurrences, but few have focused on ICU trauma surgery patients or directly compared BD to other mental disorders. We hypothesized that ICU trauma surgery patients with BD would present with lower injury severity scores but experience longer hospital stays due to altered pain perception and discharge barriers.


Methods: We conducted a cohort study of ICU admissions for trauma in Texas (Q1 2016–Q2 2024), excluding elective admissions, transfers, and against medical advice discharges. Trauma surgery patients were identified using CCSR categories INJ004–006 and MST009–011, MST015. BD was identified with ICD-10-CM codes F31x. The exposure was a categorical variable with levels no mental disorders, BD, and other mental disorders. We applied overlap propensity score weighting and report adjusted risk ratios and 95% confidence intervals (aRR [95% CI]). AI assisted with grammar and structure.


Results: Among 57,559 hospitalizations, 1,232 (2.1%) had BD and 11,688 (20.3%) had other mental disorders. BD patients were younger (32% aged ≥65 vs 61% (none), 66% (other)). Mean injury severity score was lowest in other mental disorders (8.5), vs 9.9 (BD) and 10.4 (none). Length of stay was longest in BD (8.8 days) vs 8.0 (other) and 8.0 (none). On adjusted analysis, BD patients had longer stay (aRR 1.07 [1.01–1.13]) compared to those without mental disorders and similar length of stay compared to those with other mental disorders (aRR 0.97 [0.92–1.04]).


Conclusions: BD patients were younger and had lower injury severity scores, yet experienced longer lengths of stay, revealing a disconnect between the physical trauma sustained and the course of recovery. This pattern may stem from challenges in altered pain perception, symptom reporting, delayed discharge due to psychosocial barriers, or gaps in coordinating care. Our findings suggest that trauma recovery in this population may benefit from early psychiatric involvement. By addressing both the medical and mental health needs of these patients, trauma systems can reduce inefficiencies and better support recovery beyond the acute injury.