Association of Gender, Race, Mechanism of Injury on Alcohol Use, Posttraumatic Stress Disorder, and Depression in Trauma

Abstract

Background: There is a paucity of literature documenting whether trauma patients with different mechanisms of injury have different rates of hazardous alcohol use and/or risk for depression and posttraumatic stress disorder.

Objective: The purpose of this article is to determine whether there are associations between mechanism of injury, hazardous drinking, depression, and posttraumatic stress disorder. Secondary objectives were to examine associations prior to and after the onset of the COVID-19 pandemic.

Methods: This is a retrospective cohort study of 5 years of trauma registry data of adult trauma patients (older than 18 years) admitted to a Midwestern Level I trauma center conducted from January 2016 to November 2020. Multivariable logistic regression analyses were performed to explore the association of gender, race, and mechanism of injury on hazardous drinking and posttraumatic stress disorder and depression.

Results: A total of 9,392 trauma patients completed the Alcohol Use Disorders Identification Test-Consumption Items to identify hazardous drinking, and 5,012 completed the Injured Trauma Survivor Screen to identify risk for developing posttraumatic stress disorder and/or depression. The proportion of patients screening positive for hazardous drinking was higher for motor vehicle collisions (21.9%) than for gunshot wounds (17.6%) or falls (18.8%; χ2(2) = 14.311, p < .001). Those involved in motor vehicle collisions were also at a higher risk for the development of depression and posttraumatic stress disorder (54.5%) relative to falls (33.5%) but not gunshot wounds (50.7%; χ2(2) = 200.185, p < .001). The impact of COVID-19 revealed increased hazardous drinking, depression, and posttraumatic stress disorder in patients with falls and motor vehicle collisions but not gunshot wounds.

Conclusions: Motor vehicle collision patients are at most risk for hazardous drinking concomitant with risk for depression and posttraumatic stress disorder. These results help focus future research efforts toward interventions that can reduce these risks.