Long-term follow-up of patients treated for traumatic injury regarding physical and psychological function and health-related quality of life

Abstract

Purpose

Trauma patients often suffer for long time after their injury with physical and psychological problems. Patient-reported outcome measurements (PROM) help us to understand outcomes beyond mortality. The aim of the study was to describe a sample of Swedish trauma patients, regarding their physical function, psychological morbidity, and quality of life after trauma.

Methods

The study population was sourced from the Swedish Trauma Register: taking 1 month of data from five hospitals, over three consecutive years. 218 patients met the inclusion criteria, 147 data sets were used. Inclusion criteria included: age ≥ 18; New Injury Severity Scale (NISS) ≥ 9; and discharged alive. Data were collected at 3, 6, and 12 months after the trauma. EuroQol-5D (EQ-5D), Posttraumatic Symptom Scale-10 (PTSS-10) questionnaires and Glasgow Outcome Score (GOS) instrument were used with additional questions about pain and return to work.

Results

12 months after the trauma: full functional recovery (GOS 5) was seen in 68% of the patients; 59% reported difficult or moderate pain or discomfort; and 44.5% of the patients had returned to work. In EQ-5D mobility dimension, no recovery was evident between 6 and 12 months. Twenty percent of the patients had significant symptoms for PTSD after 6 months and 16% after 3 months and 12 months.

Conclusion

Trauma patients had decreased physical function and psychological morbidity up to 1 year after the initial injury. Incorporating PROM in the follow-up after trauma is important to understand the patient’s perspective of care and treatment.

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Acknowledgements

We would like to thank the trauma registry nurses at the five hospitals that participated in the study and made it possible. We also are grateful to all the patients who answered the questions and a great thank you to Elizabeth Mårtenson for her help with language review.

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Affiliations

Authors

Contributions

The study was designed by GW and OB. Data were collected by GW. Data analysis was performed by OB. Figures and tables were prepared by OB and GW. The manuscript draft was written by GW. All authors analyzed and interpreted the data and critical reviewed the manuscript. All authors have read and approved the final manuscript. Essential aspects of the study have been published in Swedish as a master thesis by GW at Örebro University.

Corresponding author

Correspondence to Gunilla Wihlke.

Ethics declarations

Approval was obtained from the Regional Ethics Committee in Stockholm, August 2016. Reference 2016/1333-31/2.

Conflict of interest

The authors GW, LS, TT, OB declare that they have no conflict of interest.

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Wihlke, G., Strömmer, L., Troëng, T. et al. Long-term follow-up of patients treated for traumatic injury regarding physical and psychological function and health-related quality of life. Eur J Trauma Emerg Surg 47, 129–135 (2021). https://doi.org/10.1007/s00068-019-01170-w

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Keywords

  • Trauma
  • Outcome
  • Quality of life
  • PTSS-10
  • EQ-5D