PIT1 HEALTH STATUS AND RECOVERY PATTERNS ONE YEAR AFTER TRAUMA IN SEVERELY INJURED PATIENTS

Abstract

Risk factors for disabilities in severely injured patients are unknown. Most studies are retrospective in design or did not analyse 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 gain more insight into the HS and recovery patterns twelve months after a severe trauma. A multicentre prospective observational cohort study was conducted. Adult trauma patients with severe injuries (Injury Severity Score (ISS) ≥ 16) were included from August 2015 until November 2016 if they were admitted to one of the hospitals in our region. 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. Additionally, the risk factors for problems in the five EQ-5D dimensions of HS and cognition were analysed. A total of 239 severely injured patients were included. Pre-injury HS, hospital length of stay (H-LOS), ISS, ASA classification and extremity injuries are significant risk factors for a lower HS. A 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 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. Lower pre-injury HS, longer H-LOS, 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.