Recent data have shown that patients with depression have worse outcomes after stroke, as well as after a number of surgical procedures. Recent orthopedic literature is deficient with regard to outcomes relevant to individuals with psychiatric illness. This study investigated the prevalence, management patterns and surgical outcomes of patients with psychiatric illnesses who sustain polytrauma.

Data of patients with trauma from a level-I trauma center were reviewed. All presented with femoral or axial skeletal fractures between October of 2010 and February of 2013. Records were reviewed to identify psychiatric disorders that were either already part of the record or were entered as part of the trauma intake. Complications in the postoperative period were then determined and compared between those with and those without a psychiatric diagnosis.

Data were reviewed of 332 patients with surgically treated orthopedic trauma. Of these, psychiatric disorders were present in 39.2%. Depression, identified in 22.3% and substance abuse in 16.9% were the most common. Of the sixty-six patients who experienced at least one post-operative complication, 42.4% had a pre-existing psychiatric illness, including 37.9% with a diagnosis of depression. Independent predictors of postoperative complications included male gender (OR 2.78), those with higher injury severity scores (OR 1.079) and patients with depression (OR 2.96)．Of note, patients treated on the orthopedic trauma service were less likely to have their home psychiatric medications restarted, as compared to those on the general trauma service.

This study of patients with orthopedic polytrauma found that psychiatric illness is common in these patients, and that those with depression have a higher likelihood of postoperative complications.