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Erschienen in: European Journal of Trauma and Emergency Surgery 4/2016

11.08.2015 | Original Article

Health status and return to work in trauma patients at 3 and 6 months post-discharge: an Australian major trauma centre study

verfasst von: M. M. Dinh, K. Cornwall, K. J. Bein, B. J. Gabbe, B. A. Tomes, R. Ivers

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2016

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Abstract

Introduction

The aim of this study was to describe post-discharge outcomes, and determine predictors of 3 and 6 months health status outcomes in a population of trauma patients at an inner city major trauma centre.

Methods

This was a prospective cohort study of adult trauma patients admitted to this hospital with 3 and 6 months post-discharge outcomes assessment. Outcome measures were the Physical Component Scores (PCS) and Mental Component Scores (MCS) of the Short Form 12, EQ-5D, and return to work (in any capacity) if working prior to injury. Repeated measures mixed models and generalised estimating equation models were used to determine predictors of outcomes at 3 and 6 months.

Results

One hundred and seventy-nine patients were followed up. Patients with lower limb injuries reported lower mean PCS scores between 3 and 6 months (coefficient −4.21, 95 % CI −7.58, −0.85) than those without lower limb injuries. Patients involved in pedestrian incidents or assaults and those with pre-existing mental health diagnoses reported lower mean MCS scores. In adjusted models upper limb injuries were associated with reduced odds of return to work at 3 and 6 months (OR 0.20, 95 % CI 0.07, 0.57) compared to those without upper limb injuries.

Discussion

Predictors of poorer physical health status were lower limb injuries and predictors of mental health were related to the mechanism of injury and past mental health. Increasing injury severity score and upper limb injuries were the only predictors of reduced return to work. The results provide insights into the feasibility of routine post-discharge follow-up at a trauma service level.
Literatur
1.
Zurück zum Zitat Livingstone DH, Tripp T, Biggs C, Lavery RF. A fate worse than death? Long term outcome of trauma patients admitted to a surgical intensive care unit. J. 2009;67:341–9. Livingstone DH, Tripp T, Biggs C, Lavery RF. A fate worse than death? Long term outcome of trauma patients admitted to a surgical intensive care unit. J. 2009;67:341–9.
2.
Zurück zum Zitat Cameron PA, Gabbe B, McNeil J. The importance of quality of survival as an outcome measure for an integrated trauma system. Injury. 2006;37:1178–84.CrossRefPubMed Cameron PA, Gabbe B, McNeil J. The importance of quality of survival as an outcome measure for an integrated trauma system. Injury. 2006;37:1178–84.CrossRefPubMed
3.
Zurück zum Zitat Sampalis JS, Liberman M, Davis L, Angelopoulos J, Longo N, Joch M, et al. Functional status and quality of life in survivors of injury treated at tertiary trauma centres: what are we neglecting? J Trauma. 2006;60:806–13.CrossRefPubMed Sampalis JS, Liberman M, Davis L, Angelopoulos J, Longo N, Joch M, et al. Functional status and quality of life in survivors of injury treated at tertiary trauma centres: what are we neglecting? J Trauma. 2006;60:806–13.CrossRefPubMed
4.
Zurück zum Zitat Grossman M, Scaff DW, Miller D, Reed J, Hoey B, Anderson H. Functional outcomes in octogenarian trauma. J Trauma. 2003;55:26–32.CrossRefPubMed Grossman M, Scaff DW, Miller D, Reed J, Hoey B, Anderson H. Functional outcomes in octogenarian trauma. J Trauma. 2003;55:26–32.CrossRefPubMed
5.
Zurück zum Zitat Fort E, Bouffard E, Charnay P, Bernard M, Boisson D, Laumon B, Hours M. Return to work following road accidents. Factors associated with late return to work. J Rehabil Med. 2011;43:283–91.CrossRefPubMed Fort E, Bouffard E, Charnay P, Bernard M, Boisson D, Laumon B, Hours M. Return to work following road accidents. Factors associated with late return to work. J Rehabil Med. 2011;43:283–91.CrossRefPubMed
6.
Zurück zum Zitat Vles WL, Steyerberg EW, Essink-Bot ML, van Beek EF, Meeuwis JD, Leenen LPH. Prevalence and determinants of disabilities and return to work after major trauma. J Trauma. 2005;58:126–35.CrossRefPubMed Vles WL, Steyerberg EW, Essink-Bot ML, van Beek EF, Meeuwis JD, Leenen LPH. Prevalence and determinants of disabilities and return to work after major trauma. J Trauma. 2005;58:126–35.CrossRefPubMed
7.
Zurück zum Zitat Jorge RE, Robinson RG, Moser D, Tateno A, Crespo Facorro B, Arndt S. Major depression following traumatic brain injury. Arch Gen Psychiatry. 2004;61:42–50.CrossRefPubMed Jorge RE, Robinson RG, Moser D, Tateno A, Crespo Facorro B, Arndt S. Major depression following traumatic brain injury. Arch Gen Psychiatry. 2004;61:42–50.CrossRefPubMed
8.
Zurück zum Zitat Gould KR, Ponsford JL, Johnston L, Schonberger M. Relationship between psychiatric disorders and 1 year psychosocial outcome following traumatic brain injury. J Head Trauma Rehabil. 2011;26(1):79–89.CrossRefPubMed Gould KR, Ponsford JL, Johnston L, Schonberger M. Relationship between psychiatric disorders and 1 year psychosocial outcome following traumatic brain injury. J Head Trauma Rehabil. 2011;26(1):79–89.CrossRefPubMed
9.
Zurück zum Zitat Zatzick D, Jurkovich GJ, Rivara FP, Wang J, Fan MY, Joesch J, MacKenzie E. A National US Survey of post traumatic stress disorder, depression, and work and functional outcomes after hospitalisation for traumatic injury. Ann Surg. 2008;248:429–37.PubMed Zatzick D, Jurkovich GJ, Rivara FP, Wang J, Fan MY, Joesch J, MacKenzie E. A National US Survey of post traumatic stress disorder, depression, and work and functional outcomes after hospitalisation for traumatic injury. Ann Surg. 2008;248:429–37.PubMed
10.
Zurück zum Zitat Urquhart DM, Williamson OD, Gabbe BJ, Cicuttini FM, Cameron PA, Richardson MD, Edwards ER. Outcomes of patients with orthopaedic trauma admitted to level one trauma centres. ANZ J Surg. 2006;76:600–6.CrossRefPubMed Urquhart DM, Williamson OD, Gabbe BJ, Cicuttini FM, Cameron PA, Richardson MD, Edwards ER. Outcomes of patients with orthopaedic trauma admitted to level one trauma centres. ANZ J Surg. 2006;76:600–6.CrossRefPubMed
11.
Zurück zum Zitat Gabbe BJ, Cameron PA, Williamson OD, Edwards ER, Graves SE, Richardson MD. The relationship between compensable status and long term patient outcomes following orthopaedic trauma. Med J Aust. 2007;187(1):14–7.PubMed Gabbe BJ, Cameron PA, Williamson OD, Edwards ER, Graves SE, Richardson MD. The relationship between compensable status and long term patient outcomes following orthopaedic trauma. Med J Aust. 2007;187(1):14–7.PubMed
12.
Zurück zum Zitat Cameron CM, Kliewer EV, Purdie DM, McClure RJ. Long term health outcomes after injury in working age adults: a systematic review. J Epidemiol Community Health. 2006;60(4):341–4.CrossRefPubMedPubMedCentral Cameron CM, Kliewer EV, Purdie DM, McClure RJ. Long term health outcomes after injury in working age adults: a systematic review. J Epidemiol Community Health. 2006;60(4):341–4.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Gabbe BJ, Sutherland AM, Hart MJ, Cameron PA. Population-based capture of long-term functional and quality of life outcomes after major trauma: the experiences of the Victorian State Trauma Registry. J Trauma. 2010;69(3):532–6 (discussion 536).CrossRefPubMed Gabbe BJ, Sutherland AM, Hart MJ, Cameron PA. Population-based capture of long-term functional and quality of life outcomes after major trauma: the experiences of the Victorian State Trauma Registry. J Trauma. 2010;69(3):532–6 (discussion 536).CrossRefPubMed
14.
Zurück zum Zitat Holbrook TL, Anderson JP, Sieber WJ, Browner D, Hoyt DBJ Trauma. Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project. J Trauma. 1999;46(5):765–71 (discussion 771–773).CrossRefPubMed Holbrook TL, Anderson JP, Sieber WJ, Browner D, Hoyt DBJ Trauma. Outcome after major trauma: 12-month and 18-month follow-up results from the Trauma Recovery Project. J Trauma. 1999;46(5):765–71 (discussion 771–773).CrossRefPubMed
15.
Zurück zum Zitat Holtslag HR, van Beeck EF, Lindeman E, Leenen LP. Determinants of long-term functional consequences after major trauma. J Trauma. 2007;62(4):919–27.CrossRefPubMed Holtslag HR, van Beeck EF, Lindeman E, Leenen LP. Determinants of long-term functional consequences after major trauma. J Trauma. 2007;62(4):919–27.CrossRefPubMed
16.
Zurück zum Zitat Attenberger C, Amsler F, Gross T. Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients. Injury. 2012;43(9):1566–74.CrossRefPubMed Attenberger C, Amsler F, Gross T. Clinical evaluation of the Trauma Outcome Profile (TOP) in the longer-term follow-up of polytrauma patients. Injury. 2012;43(9):1566–74.CrossRefPubMed
17.
Zurück zum Zitat Mitchell R, Watson WL, Curtis K, Harris I, McDougall P. Difficulties in establishing long-term trauma outcomes data collections. Could trauma outcomes be routinely monitored in New South Wales, Australia: piloting a 3 months follow-up? Injury. 2012;43(1):96–102.CrossRefPubMed Mitchell R, Watson WL, Curtis K, Harris I, McDougall P. Difficulties in establishing long-term trauma outcomes data collections. Could trauma outcomes be routinely monitored in New South Wales, Australia: piloting a 3 months follow-up? Injury. 2012;43(1):96–102.CrossRefPubMed
20.
Zurück zum Zitat Gabbe BJ, Cameron PA, Hannaford AP, Sutherland AM, McNeil JJ. Routine follow up of major trauma patients from trauma registries: what are the outcomes? J Trauma. 2006;61(6):1393–9.CrossRefPubMed Gabbe BJ, Cameron PA, Hannaford AP, Sutherland AM, McNeil JJ. Routine follow up of major trauma patients from trauma registries: what are the outcomes? J Trauma. 2006;61(6):1393–9.CrossRefPubMed
21.
Zurück zum Zitat Aitken LM, Davey TM, Ambrose J, Connelly LB, Swanson C, Bellamy N. Health outcomes of adults 3 months after injury. Injury. 2007;38(1):19–26 Epub 2006 Sep 25.CrossRefPubMed Aitken LM, Davey TM, Ambrose J, Connelly LB, Swanson C, Bellamy N. Health outcomes of adults 3 months after injury. Injury. 2007;38(1):19–26 Epub 2006 Sep 25.CrossRefPubMed
22.
Zurück zum Zitat Brinck T, Handolin L, Paffrath T, Lefering R. Trauma registry comparison: six-year results in trauma care in Southern Finland and Germany. Eur J Trauma Emerg Surg. 2014. (epub ahead of print). Brinck T, Handolin L, Paffrath T, Lefering R. Trauma registry comparison: six-year results in trauma care in Southern Finland and Germany. Eur J Trauma Emerg Surg. 2014. (epub ahead of print).
23.
Zurück zum Zitat Jurkovich GJ, Mock C. Systematic review of trauma system effectiveness based on registry comparisons. J Trauma. 1999;47(3 Suppl):S46–55.CrossRefPubMed Jurkovich GJ, Mock C. Systematic review of trauma system effectiveness based on registry comparisons. J Trauma. 1999;47(3 Suppl):S46–55.CrossRefPubMed
24.
Zurück zum Zitat Langley J, Derrett S, Davie G, Ameratunga S, Wyeth E. A cohort study of short-term functional outcomes following injury: the role of pre-injury socio-demographic and health characteristics, injury and injury-related healthcare. Health Qual Life Outcomes. 2011;9:68. doi:10.1186/1477-7525-9-68.CrossRefPubMedPubMedCentral Langley J, Derrett S, Davie G, Ameratunga S, Wyeth E. A cohort study of short-term functional outcomes following injury: the role of pre-injury socio-demographic and health characteristics, injury and injury-related healthcare. Health Qual Life Outcomes. 2011;9:68. doi:10.​1186/​1477-7525-9-68.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Meerding WJ, Looman CW, Essink-Bot ML, Toet H, Mulder S, van Beeck EF. Distribution and determinants of health and work status in a comprehensive population of injury patients. J Trauma. 2004;56(1):150–61.CrossRefPubMed Meerding WJ, Looman CW, Essink-Bot ML, Toet H, Mulder S, van Beeck EF. Distribution and determinants of health and work status in a comprehensive population of injury patients. J Trauma. 2004;56(1):150–61.CrossRefPubMed
26.
Zurück zum Zitat Michaels AJ, Michaels CE, Smith JS, Moon CH, Peterson C, Long WB. Outcome from injury: general health, work status, and satisfaction 12 months after trauma. J Trauma. 2000;48(5):841–8 (discussion 848–850).CrossRefPubMed Michaels AJ, Michaels CE, Smith JS, Moon CH, Peterson C, Long WB. Outcome from injury: general health, work status, and satisfaction 12 months after trauma. J Trauma. 2000;48(5):841–8 (discussion 848–850).CrossRefPubMed
27.
Zurück zum Zitat Dorstyn DS, Mathias JL, Denson LA. Psychosocial outcomes of telephone-based counselling for adults with an acquired physical disability: a meta-analysis. Rehabil Psychol. 2011;56(1):1–14. doi:10.1037/a0022249.CrossRefPubMed Dorstyn DS, Mathias JL, Denson LA. Psychosocial outcomes of telephone-based counselling for adults with an acquired physical disability: a meta-analysis. Rehabil Psychol. 2011;56(1):1–14. doi:10.​1037/​a0022249.CrossRefPubMed
28.
Zurück zum Zitat Harris IA, Young JM, Rae H, Jalaludin BB, Solomon MJ. Predictors of general health after major trauma. J Trauma. 2008;64:969–74.CrossRefPubMed Harris IA, Young JM, Rae H, Jalaludin BB, Solomon MJ. Predictors of general health after major trauma. J Trauma. 2008;64:969–74.CrossRefPubMed
30.
Zurück zum Zitat Curtis KA, Mitchell RJ, Chong SS, Balogh ZJ, Reed DJ, Clark PT, et al. Injury trends and mortality in adult patients with major trauma in New South Wales. Med J Aust. 2012;197(4):233–7.CrossRefPubMed Curtis KA, Mitchell RJ, Chong SS, Balogh ZJ, Reed DJ, Clark PT, et al. Injury trends and mortality in adult patients with major trauma in New South Wales. Med J Aust. 2012;197(4):233–7.CrossRefPubMed
Metadaten
Titel
Health status and return to work in trauma patients at 3 and 6 months post-discharge: an Australian major trauma centre study
verfasst von
M. M. Dinh
K. Cornwall
K. J. Bein
B. J. Gabbe
B. A. Tomes
R. Ivers
Publikationsdatum
11.08.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 4/2016
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-015-0558-0

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