• Zoe M F Brier, Kenneth J Ruggiero, Terri A deRoon-Cassini, and Hannah C Espeleta.
• Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA. Electronic address: zmfbrier@stanford.edu.
• Injury. 2024 Dec 11: 112078112078.

BackgroundThe American College of Surgeons now requires mental health screening and follow up for hospitalized patients in trauma centers. National estimates indicate that 20-40 % of these patients will develop posttraumatic stress disorder (PTSD) and/or depression within one year post-injury. Research has identified brief bedside screens that predict PTSD and depression post-discharge, such as the Injured Trauma Survivor Screen and Peritraumatic Distress Inventory. However, false negatives are common; almost a quarter of patients with a negative bedside risk screen may develop PTSD or depression post-discharge and may not receive appropriate follow up. As such, there is critical need to improve bedside risk-screening tools. We aimed to identify demographic, social, and trauma-related predictors of mental health symptoms among patients with negative bedside screens.MethodPatients were injury survivors served by a Level I trauma center who were identified as "low risk for development of PTSD/depression" by the Injured Trauma Survivor Screen. Patient injury type and demographics were collected from the medical record.ResultsViolent injuries (e.g., gunshot wound) and lower levels of available social support predicted elevated PTSD symptoms 30-days post-injury. Lower social support also was associated with increased risk for depressive symptoms 30 days post-injury.ConclusionFindings suggest that risk-screening tools may be improved by including items that capture injury mechanism and social support. Alternatively, trauma centers should consider mental health referral for patients who have experienced violent trauma or have low levels of social support, even when bedside screening tools identify them as having low mental health risk.Copyright © 2024 Elsevier Ltd. All rights reserved.

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