Article
Health status and recovery patterns during one year after trauma in severely injured patients
Search Medline for
Authors
-
Roos Havermans
- Trauma Registry Brabant, Network Emergency Care Brabant, ETZ hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, Netherlands
-
Leonie de Munter
- Department Trauma TopCare, ETZ hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, Netherlands
-
Mariska de Jongh
- Trauma Registry Brabant, Network Emergency Care Brabant, ETZ hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, Netherlands
-
Koen Lansink
- Department of Surgery, ETZ hospital (Elisabeth-TweeSteden Ziekenhuis), Tilburg, Netherlands
| Published: | October 22, 2019 |
|---|
Outline
Text
Objectives: Risk factors for disabilities in severely injured patients are unknown. Most of the studies are retrospective in design or did not analyse the severely injured patients. The aim of the present prospective cohort study was to examine which trauma and patient related factors are risk factors for a lower health status (HS) and to reach more insight into the HS and recovery patterns during twelve months after a severe trauma.
Methods: The Brabant Injury Outcome Surveillance (BIOS-study) is a multicentre prospective observational cohort study (EbM-level II). Adult severely injured trauma patients (Injury Severity Score (ISS) > 15) were included from August 2015 till November 2016 if they were admitted to one of the hospitals of the Noord-Brabant region in the Netherlands. Outcome measures were the EuroQol5D-3L (EQ-5D utility and EQ-VAS) and the Health Utilities Index (HUI2 and HUI3) one week and one, three, six and twelve months after injury. Patient and trauma characteristics were analysed as possible risk factors with linear mixed models. The recovery patterns were analysed based on time interaction and were visualised as difference scores; the score of a patient with the variable minus the score of the patient without the variable. Additionally, the risk factors for problems in the five EQ-5D dimensions of HS and cognition were analysed.
Results and conclusion: A total of 239 (55% of total) severely injured patients participated in the BIOS-study. Pre-injury HS, hospital length of stay, ISS, American Society Anaesthesiologists (ASA) classification, employment status, single person household and extremity injuries are significant risk factors for a lower HS, see Table 1 [Tab. 1]. A significant time interaction was seen in employment status, employed patients showed an upward trend over time. Patients with an ASA II, ASA III or ASA IV classification showed a significant downward trend over time. An extremity injury is a significant risk factor in mobility problems and these patients showed a significant upward trend over time in HS. In conclusion, lower pre-injury HS, longer hospital length of stay, higher ISS, higher ASA classification, unemployment, single person household and extremity injuries are the most important risk factors for a lower HS during one year after a severe injury.
