Introduction
Methods
General setting and data collection
Responder and non-responders
Comorbidity and education
EuroQol-5D-5L and cognition
Return to work
Data analysis
Results
Study population
Inclusion overall (n = 365) | Respondents (n = 182) | Non-respondents (n = 183) | p value | |
---|---|---|---|---|
Probability of survival | 0.95 (0.81–0.98) | 0.94 (0.88–0.98) | 0.95 (0.77–0.99) | 0.554 |
Age at arrival ED (year) | 46 (28–63) | 52 (29–67) | 41 (26–55) | 0.002 |
Gender—female | 124 (34%) | 66 (36%) | 58 (32%) | 0.378 |
ISS ≥ 25 | 115 (32%) | 54 (30%) | 61 (33%) | 0.499 |
ISS | 21 (17–25) | 20 (17–25) | 21 (17–26) | 0.548 |
Penetrating injury | 8 (2.2%) | 1 (0.5%) | 7 (3.8%) | 0.067 |
Endotracheal intubation prehospital | 67 (18%) | 29 (16%) | 38 (21%) | 0.279 |
Resuscitation prehospital | 8 (2.2%) | 3 (1.6%) | 5 (2.7%) | 0.724 |
Hospital LOS (days) | 10 (5–19) | 10 (5–17) | 11 (5–21) | 0.587 |
ICU | 219 (60%) | 111 (61%) | 108 (59%) | 0.749 |
Mechanical ventilation | 121 (33%) | 55 (30%) | 66 (36%) | 0.266 |
Surgery | 183 (50%) | 91 (50%) | 92 (50%) | 1.000 |
Injuries (n) | 6 (3–9) | 6 (4–9) | 5 (3–9) | 0.548 |
Fractures (n) | 2 (1–4) | 2 (1–4) | 2 (1–4) | 0.365 |
Cause—violence | 12 (3%) | 3 (2%) | 9 (5%) | 0.381 |
Cause—traffic | 150 (41%) | 79 (43%) | 71 (39%) | |
Cause—work | 33 (9%) | 19 (10%) | 14 (8%) | |
Cause—private | 119 (33%) | 56 (31%) | 63 (34%) | |
Cause—sports | 29 (8%) | 16 (9%) | 13 (7%) | |
Cause—self-inflicted | 19 (5%) | 8 (4%) | 11 (6%) |
Overall health state, EuroQoL-5D-5L, and cognition
n | EQ-US (n = 178) | EQ-VAS (n = 174) | Limitations in health domains | ||||||
---|---|---|---|---|---|---|---|---|---|
Mobility (n = 180) | Self-care (n = 179) | Daily activities (n = 179) | Pain and discomfort (n = 179) | Anxiety and depression (n = 180) | Cognition (n = 168) | ||||
All respondents | 182 | 0.81 (0.61–0.89; 4) | 70 (60–80; 8) | 89 (48.9; 3) | 36 (19.8; 4) | 108 (59.3; 4) | 129 (70.9; 4) | 70 (38.5; 3) | 102 (56.0; 14) |
Gender | |||||||||
Male | 116 | 0.79 (0.60–0.89; 4) | 71 (60–82; 4) | 53 (46.9; 3) | 24 (21.4; 4) | 69 (61.6; 4) | 80 (71.4; 4) | 45 (39.8; 3) | 64 (60.4; 10) |
Female | 66 | 0.81 (0.60–0.89; 0) | 70 (59–80; 4) | 36 (54.5; 0) | 12 (18.2; 0) | 39 (59.1; 0) | 49 (74.2; 0) | 25 (37.9; 0) | 38 (61.3; 4) |
Age | |||||||||
0–17 | 21 | 0.89 (0.75–1.00; 0)A | 90 (76–99; 1) D | 1 (4.8; 0)D | 1 (4.8; 0) | 7 (33.3; 0)C | 11 (52.4; 0)B | 7 (33.3; 0) | 12 (60.0; 1) |
18–55 | 84 | 0.76 (0.56–0.85; 1) | 70 (59–80; 2) | 44 (53.0; 1) | 15 (18.1; 1) | 60 (72.3; 1) | 68 (81.9; 1) | 38 (45.8; 1) | 50 (62.5; 4) |
55 + | 77 | 0.82 (0.54–94; 3) | 70 (55–80; 5) | 44 (57.9; 1) | 20 (26.7; 2) | 41 (54.7; 2) | 50 (66.7; 2) | 25 (32.9; 1) | 40 (59.4; 8) |
Education (age 18 +) | |||||||||
Low | 68 | 0.74 (0.49–0.87; 3) | 65 (50–75; 5) | 40 (60.6; 2) | 18 (29.2; 3) | 48 (73,8; 3) | 51 (78.5; 3) | 32 (48.5; 2) | 46 (75.4; 7)B |
Middle | 58 | 0.81 (0.62–0.89; 1) | 74 (60–84; 2) | 29 (50.9; 1) | 9 (15.8; 1) | 35 (61,4; 1) | 43 (75.4; 1) | 22 (38.6; 1) | 29 (53.7; 4) |
High | 29 | 0.83 (0.69–0.89; 0) | 70 (63–80; 0) | 16 (55.2; 0) | 5 (17.2; 0) | 15 (51.7; 0) | 21 (72.4; 0) | 8 (27.6; 0) | 12 (44.4; 2) |
Comorbidity | |||||||||
None | 99 | 0.82 (0.66–0.91; 0)A | 75 (65–90; 5)C | 41 (41.1; 0)B | 16 (16.2; 0)A | 55 (55.6; 0) | 70 (70.7; 0) | 34 (34.3; 0) | 45 (49.5; 8)D |
1 | 50 | 0.81 (0.57–0.92; 2) | 70 (60–75; 1) | 25 (52.1; 2) | 7 (14.6; 2) | 31 (64.6; 2) | 32 (66.7; 2) | 18 (37.5; 2) | 39 (81.3; 2) |
> 1 | 33 | 0.65 (0.41–0.87; 1) | 68 (50–75; 1) | 23 (69.7; 0) | 13 (40.6; 1) | 22 (68.8; 1) | 27 (84.4; 1) | 18 (54.5; 0) | 19 (63.3; 3) |
Injury severity | |||||||||
ISS 16–24 | 128 | 0.84 (0.67–0.92; 2)D | 75 (64–85; 7)D | 55 (43.0; 0)B | 22 (17.3; 1) | 68 (53.5; 1)C | 86 (67.7; 1)A | 42 (32.8; 0)B | 63 (53.4; 10)C |
ISS 25 + | 54 | 0.66 (0.34–0.84; 2) | 60 (48–75; 1) | 34 (65.4; 2) | 14 (26.9; 2) | 40 (76.9; 2) | 43 (82.7; 2) | 28 (53.8; 2) | 39 (78.0; 4) |
MAIS | |||||||||
Head | |||||||||
None | 62 | 0.78 (0.48–0.89; 1) | 70 (50–84; 2) | 31 (50.8; 1) | 13 (21.3; 1) | 35 (57.4; 1) | 49 (80.3; 1) | 25 (41.0; 1) | 31 (51.7; 2)D |
1–2 | 27 | 0.81 (0.60–0.90; 2) | 70 (60–83; 1) | 15 (57.7; 1) | 7 (28.0; 2) | 17 (68.0; 2) | 19 (76.0; 2) | 9 (34.6; 1) | 8 (36.4; 5) |
3 + | 93 | 0.81 (0.61–0.92; 1) | 72 (60–80; 5) | 43 (46.2; 0) | 16 (17.2; 0) | 56 (60.2; 0) | 61 (65.6; 0) | 36 (38.7; 0) | 64 (73.6; 6) |
Face | |||||||||
None | 124 | 0.81 (0.60–0.89; 3) | 71 (55–85; 5) | 60 (49.2; 2) | 23 (19.0; 3) | 70 (57.9; 3) | 90 (74.4; 3) | 49 (40.2; 2) | 62 (53.9; 8)A |
1–2 | 53 | 0.79 (0.57–0.91; 1) | 71 (60–80; 3) | 25 (47.2; 0) | 12 (22.6; 0) | 34 64.2(; 0) | 34 (64.2; 0) | 18 (34.0; 0) | 36 (73.5; 4) |
3 + | 5 | 0.74 (0.44–0.82; 0) | 70 (53–73; 0) | 4 (80.0; 0) | 1 (20.0; 0) | 4 (80.0; 0) | 5 (100.0; 0) | 3 (60.0; 0) | 5 (100.0; 0) |
Neck | |||||||||
None | 176 | 0.81 (0.60–0.89; 4) | 71 (60–82; 8) | 86 (49.4; 2) | 34 (19.7; 3) | 102 (59.0; 3) | 123 (71.1; 3) | 64 (36.8; 2) B | 99 (60.7; 13) |
1–2 | 1 | 0.74 (0.74–0.74; 0) | 65 (65–65; 0) | 1 (100.0; 0) | 0 (0.0; 0) | 1 (100.0; 0) | 1 (100.0; 0) | 1 (100.0; 0) | 0 (0.0; 0) |
3 + | 5 | 0.64 (0.59–0.77; 0) | 67 (63–73; 0) | 2 (40.0; 0) | 2 (40.0; 0) | 5 (100.0; 0) | 5 (100.0; 0) | 5 (100.0; 0) | 4 (80.0; 0) |
Thorax | |||||||||
None | 92 | 0.81 (0.53–0.92; 0) | 75 (60–85; 4) | 46 (50.0; 0) | 22 (23.9;) | 53 (57.6; 0) | 63 (68.5; 0) | 30 (32.6; 0) | 53 (61.6; 6) |
1–2 | 21 | 0.74 (0.46–0.85; 0) | 70 (58–83; 0) | 12 (57.1; 0) | 4 (19.0; 0) | 14 (66.7; 0) | 16 (76.2; 0) | 11 (52.4; 0) | 11 (57.9; 2) |
3 + | 69 | 0.82 (0.64–0.89; 4) | 70 (58–80; 4) | 31 (46.3; 2) | 10 (15.2; 3) | 41 (62.1; 3) | 50 (75.8; 3) | 29 (43.3; 2) | 39 (60.9; 5) |
Abdomen | |||||||||
None | 150 | 0.81 (0.61–0.89; 2) | 71 (60–80; 6) | 75 (50.3; 1) | 32 (21.5; 1) | 92 (61.7; 1) | 106 (71.1; 1) | 53 (35.6; 1) | 88 (62.4; 9) |
1–2 | 14 | 0.82 (0.61–0.94; 1) | 80 (45–90; 1) | 6 (42.9; 0) | 1 (7.7; 1) | 7 (53.8; 1) | 10 (76.9; 1) | 8 (57.1; 0) | 6 (50.0; 2) |
3 + | 18 | 0.72 (0.24–0.94; 1) | 65 (50–80; 1) | 8 (47.1; 1) | 3 (17.6; 1) | 9 (52.9; 1) | 13 (76.5; 1) | 9 (52.9; 1) | 9 (56.3; 2) |
Spine | |||||||||
None | 130 | 0.82 (0.65–0.92; 1)A | 71 (60–81; 6) | 57 (43.5; 0)A | 22 (16.9; 0) | 72 (55.4; 0) | 86 (66.2; 0)A | 49 (37.4; 0) | 79 (64.2; 7) |
1–2 | 25 | 0.75 (0.39–0.85; 2) | 70 (55–82; 2) | 15 (65.2; 2) | 6 (26.1; 2) | 16 (69.6; 2) | 20 (87.0; 2) | 10 (43.5; 2) | 13 (61.9; 4) |
3 + | 27 | 0.73 (0.46–0.85; 1) | 70 (60–80; 0) | 17 (65.4; 1) | 8 (30.8; 1) | 20 (76.9; 1) | 23 (88.5; 1) | 11 (42.3; 1) | 11 (44.0; 2) |
Upper extremity | |||||||||
None | 106 | 0.81 (0.59–0.92; 0) | 70 (60–85; 1) | 55 (51.9; 0) | 21 (19.8; 0)A | 58 (54.7; 0) | 71 (67.0; 0) | 39 (36.8; 0) | 60 (60.6; 16) |
1–2 | 74 | 0.80 (0.60–0.89; 4) | 70 (58–80; 7) | 33 (45.8; 2) | 13 (18.3; 3) | 48 (67.6; 3) | 56 (78.9; 3) | 30 (41.7; 2) | 42 (61.8; 6) |
3 + | 2 | 0.71 (0.66–0.71; 0) | 65 (50–65; 0) | 1 (50.0; 0) | 2 (100.0; 0) | 2 (100.0; 0) | 2 (100.0; 0) | 1 (50.0; 0) | 1 (50.0; 0) |
Lower extremity | |||||||||
None | 115 | 0.82 (0.61–1.00; 2) A | 75 (60–85; 5) | 48 (41.7; 0)D | 23 (20.2; 1) | 61 (53.5; 0)A | 72 (63.2; 0)C | 42 (36.5; 0) | 62 (57.4; 7) |
1–2 | 34 | 0.82 (0.66–0.86; 1) | 70 (65–82; 2) | 16 (48.5; 1) | 4 (12.1; 1) | 22 (66.7; 1) | 29 (87.9; 1) | 12 (36.4; 1) | 20 (69.0; 5) |
3 + | 33 | 0.66 (0.30–0.84; 1) | 60 (50–79; 1) | 25 (78.1; 1) | 9 (28.1; 1) | 25 (78.1; 1) | 28 (87.5; 1) | 16 (50.0; 1) | 21 (65.6; 1) |
External | |||||||||
None | 159 | 0.81 (0.61–0.89; 4) | 71 (60–82; 8) | 77 (49.0; 2) | 30 (19.2; 3) | 97 (62.2; 3) | 110 (70.5; 3) | 58 (36.9; 2) | 86 (58.1; 11) |
1–2 | 17 | 0.76 (0.51–0.89; 0) | 70 (48–83; 0) | 9 (52.9; 0) | 4 (23.5; 0) | 9 (52.9; 0) | 14 (82.4; 0) | 9 (52.9; 0) | 11 (73.3; 2) |
3 + | 6 | 0.76 (0.53–0.90; 0) | 60 (39–80; 0) | 3 (50.0; 0) | 2 (33.3; 0) | 2 (33.3; 0) | 5 (83.3; 0) | 3 (50.0; 0) | 6 (100.0; 0) |
Return to work
Overall (n = 100)* | Level of return to work | ||||
---|---|---|---|---|---|
Fully (n = 37) | Partially (n = 31) | No return (n = 32) | p value | ||
Female | 28 (28%) | 7 (19%) | 12 (39%) | 9 (28%) | 0.194 |
Age 18–55 | 69 (71%) | 25 (36%) | 22 (32%) | 22 (32%) | 0.912 |
Education | |||||
Low | 39 (40%) | 10 (27%) | 13 (42%) | 16 (53%) | 0.107 |
Middle | 39 (40%) | 16 (43%) | 11 (36%) | 12 (40%) | |
High | 20 (20%) | 11 (30%) | 7 (23%) | 2 (7%) | |
Comorbidity | |||||
None | 62 (62%) | 28 (76%) | 16 (52%) | 18 (56%) | 0.297 |
1 | 26 (26%) | 6 (16%) | 10 (32%) | 10 (31%) | |
> 1 | 12 (12%) | 3 (8%) | 5 (16%) | 4 (13%) | |
ISS 16–24 | 68 (68%) | 30 (81%) | 22 (71%) | 16 (50%) | 0.020 |
MAIS | |||||
Head | |||||
None | 35 (35%) | 11 (30%) | 12 (39%) | 12 (38%) | 0.815 |
1–2 | 18 (18%) | 8 (22%) | 6 (19%) | 4 (13%) | |
3 + | 47 (47%) | 18 (49%) | 13 (42%) | 16 (50%) | |
Face | |||||
None | 69 (69%) | 26 (70%) | 19 (61%) | 24 (75%) | 0.674 |
1–2 | 26 (26%) | 10 (27%) | 9 (29%) | 7 (22%) | |
3 + | 5 (5%) | 1 (3%) | 3 (10%) | 1 (3%) | |
Neck | |||||
None | 96 (96%) | 36 (97%) | 30 (97%) | 30 (94%) | 0.432 |
1–2 | 1 (1%) | – | 1 (3%) | – | |
3 + | 3 (3%) | 1 (3%) | – | 2 (6%) | |
Thorax | |||||
None | 41 (41%) | 18 (49%) | 10 (32%) | 13 (41%) | 0.338 |
1–2 | 15 (15%) | 3 (8%) | 8 (26%) | 4 (13%) | |
3 + | 44 (44%) | 16 (43%) | 13 (42%) | 15 (47%) | |
Abdomen | |||||
None | 82 (82%) | 30 (81%) | 26 (84%) | 26 (81%) | 0.479 |
1–2 | 8 (8%) | 5 (14%) | 1 (3%) | 2 (6%) | |
3 + | 10 (10%) | 2 (5%) | 4 (13%) | 4 (13%) | |
Spine | |||||
None | 64 (64%) | 23 (62%) | 21 (68%) | 20 (63%) | 0.282 |
1–2 | 18 (18%) | 9 (24%) | 2 (7%) | 7 (22% | |
3 + | 18 (18%) | 5 (14%) | 8 (26%) | 5 (16%) | |
Upper extremity | |||||
None | 58 (58%) | 22 (60%) | 19 (61%) | 17 (53%) | 0.819 |
1–2 | 40 (40%) | 15 (41%) | 11 (36%) | 14 (44%) | |
3 + | 2 (2%) | – | 1 (3%) | 1 (3%) | |
Lower extremity | |||||
None | 60 (60%) | 23 (62%) | 18 (58%) | 19 (60%) | 0.881 |
1–2 | 20 (20%) | 8 (22%) | 7 (23%) | 5 (16%) | |
3 + | 20 (20%) | 6 (16%) | 6 (20%) | 8 (25%) | |
External | |||||
None | 87 (87%) | 35 (95%) | 28 (90%) | 24 (75%) | 0.138 |
1–2 | 10 (10%) | 2 (5%) | 2 (7%) | 6 (19%) | |
3 + | 3 (3%) | – | 1 (3%) | 2 (6%) |