Long-term outcome in 324 polytrauma patients: what factors are associated with posttraumatic stress disorder and depressive disorder symptoms?

Lisa Falkenberg,Boris A Zelle,Philipp Mommsen,Christian Krettek,Christian Probst,Marcel Winkelmann,Hans-Christoph Pape,Christian Zeckey,Martin Panzica

doi:10.1186/s40001-017-0282-9

Abstract

BackgroundPhysical impairment is well-known to last for many years after a severe injury, and there is a high impact on the quality of the survivor’s life. The purpose of this study was to examine if this is also true for psychological impairment with symptoms of posttraumatic stress disorder or depression after polytrauma.DesignRetrospective cohort outcome study.SettingLevel I trauma centre.Population637 polytrauma trauma patients who were treated at our Level I trauma centre between 1973 and 1990. Minimum follow-up was 10 years after the injury.MethodsPatients were asked to fill in a questionnaire, including parts of the Posttraumatic Stress Diagnostic Scale, the Impact of Event Scale-Revised and the German Hospital Anxiety and Depression Scale, to evaluate mental health. Clinical outcome was assessed before by standardised scores.ResultsThree hundred and twenty-four questionnaires were evaluated. One hundred and forty-nine (45.9%) patients presented with symptoms of mental impairment. Quality of life was significantly higher in the mentally healthy group, while the impaired group achieved a lower rehabilitation status.ConclusionsMental impairment can be found in multiple trauma victims, even after 10 years or more. Treating physicians should not only focus on early physical rehabilitation but also focus on early mental rehabilitation to prevent long-term problems in both physical and mental disability.

Highlights

Physical impairment is well-known to last for many years after a severe injury, and there is a high impact on the quality of the survivor’s life
One hundred and forty-nine (45.9%) patients presented with symptoms of mental impairment
Mental impairment can be found in multiple trauma victims, even after 10 years or more

Summary

Introduction

Physical impairment is well-known to last for many years after a severe injury, and there is a high impact on the quality of the survivor’s life. The survival rate of multiple trauma patients has increased to 85–88%. Previous studies with a follow-up of 12–28 months found female gender [8,9,10] and lower age [11, 12] to be associated with the development of mental impairment after severe physical trauma. A good functional status after discharge is related to a higher return to work rate [13]. This is referred to as physical impairment and as psychological impairment to a considerable degree [14]

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