• J C Van Ditshuizen, M A C De Jongh, HartogD DenDDTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Trauma Centre Southwest-Netherlands, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., LansinkK W WKWWNetwork Emergency Care Brabant, Brabant Trauma Registry, Tilburg, the Netherlands; Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands., VerhofstadM H JMHJTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., Van LieshoutE M MEMMTrauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands., BIOS-group, and Dutch Trauma Registry Southwest.
• Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands; Trauma Centre Southwest-Netherlands, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. Electronic address: j.vanditshuizen@erasmusmc.nl.
• Injury. 2025 Feb 1; 56 (2): 112152112152.

IntroductionConcentration of trauma care in trauma network has resulted in different trauma populations across designated levels of trauma care.ObjectiveDescribing psychological health status, by means of the impact event scale (IES) and the hospital anxiety and depression scale (HADS), of major trauma patients one and two years post-trauma across different levels of trauma care in trauma networks.MethodsA multicentre retrospective cohort study was conducted.Inclusion Criteriaaged ≥ 18 and an Injury Severity Score (ISS) > 15, surviving their injuries one year after trauma. Psychological health status was self-reported with HADS and IES. Subgroup analysis, univariate, and multivariable analysis were done on level of trauma care and trauma region for HADS and IES as outcome measures.ResultsPsychological health issues were frequently reported (likely depressed n = 31, 14.7 %); likely anxious n = 32, 15.2 %; indication of a post-traumatic stress disorder n = 46, 18.0 %). Respondents admitted to a level I trauma centre reported more symptoms of anxiety (3, P25-P75 1-6 vs. 5, P25-P75 2-9, p = 0.002), depression (2, P25-P75 1-5 vs. 5, P25-P75 2-9, p < 0.001), and post-traumatic stress (6, P25-P75 0-15 vs. 13, P25-P75 3-33, p = 0.001), than patients admitted to a non-level I trauma centre. Differences across trauma regions were reported for depression (3, P25-P75 1-6 vs. 4, P25-P75 2-10, p = 0.030) and post-traumatic stress (7, P25-P75 0-18 vs. 15, P25-P75 4-34, p < 0.001).ConclusionsMajor trauma patients admitted to a level I trauma centre have more depressive, anxious, and post-traumatic stress symptoms than when admitted to a non-level I trauma centre. These symptoms differed across trauma regions, indicating populations differences. Level of trauma care and trauma region are important when analysing psychological health status.Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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