Pre-traumatic, trauma- and treatment-related determinants of self-rated health after a severe trauma

Abstract

This analysis examines the relationship between different pre-traumatic, trauma and treatment related factors and self-rated health of heavily injured patients after a severe trauma. A written questionnaire was sent to 121 seriously injured patients who were predominantly hurt by traffic or work related accidents and were treated between june 1996 and july 2000 in two hospitals in North Rhine-Westphalia. Information regarding age, gender, education, occupation, income, injury severity, injury of extremities, state anxiety, date of discharge and taking part in a cognitive behavioural intervention were gathered during the inpatient stage, information about self-rated health, patients subjective evaluation of medical treatment outcome and shared decision making with physicians were gathered about four years after trauma. Results of a multivariate stepwise linear regression show that poor self-rated health is significantly associated with a negative subjective evaluation of medical treatment outcome, less shared decision making behaviour of physician, low socio-economic status and older age. Treatment but not trauma related factors and socio-economic and demographic characteristics of patients are significantly associated with self-rated health of severely injured patients. It seems to be important for long-term health to take into account: 1.) patient reported outcomes e.g. subjective evaluation of medical treatment outcome, 2.) shared decision making behaviour of physicians and 3.) to be aware of patients with low socio-economic status or 4.) older age as a high risk population.