Impact of chronic illness on functional outcomes and quality of life among injured older adults

Abstract

IntroductionTrauma care for injured older adults is complicated by pre-existing chronic illness. We examined the association between chronic illness and post-injury function, healthcare utilization and quality of life. MethodsTrauma patients ≥65 years with an Injury Severity Score (ISS) ≥9 discharged from one of three level-1 trauma centers were interviewed 6-12 months post-discharge. Patients were asked about new functional limitations, injury-related emergency department (ED) visits or readmission, and health-related quality of life (HRQoL). Trauma registry data was used to determine presence of seven chronic illnesses. Adjusted regression models examined associations between increasing number of chronic illness (0, 1, ≥2) and outcomes. ResultsOf 1,379 patients, 46.5% had at least one chronic illness. In adjusted analysis, any chronic illness was associated with higher odds of new functional limitation (1 chronic illness, OR1.54, CI: 1.20-1.97; ≥2, OR1.69, CI: 1.16-2.48) and worse physical health-related QoL (1 chronic illness adj. mean diff= -4.0, CI: -5.6 to -2.5; ≥2 adj. mean diff.= -4.4, CI: -7.3 to -1.4, p<0.01). Mental health post-injury was consistent with population norms across all groups. ConclusionPresence of any chronic illness in older adults is associated with new functional limitations and worse physical HRQoL post-injury, but unchanged mental health. Focused interventions are needed to support long-term recovery.