M M Dinh1,2,3, K Cornwall4, K J Bein5, B J Gabbe6, B A Tomes7, R Ivers8. 1. Department of Trauma Services, Royal Prince Alfred Hospital, Level 10, Missenden Road, Camperdown, NSW, 2050, Australia. dinh.mm@gmail.com. 2. Sydney Medical School, Sydney, Australia. dinh.mm@gmail.com. 3. Injury Division, The George Institute for Global Health, Sydney, Australia. dinh.mm@gmail.com. 4. Department of Trauma Services, Royal Prince Alfred Hospital, Level 10, Missenden Road, Camperdown, NSW, 2050, Australia. 5. Emergency Department, Royal Prince Alfred Hospital, Camperdown, Australia. 6. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. 7. Sydney Medical School, Sydney, Australia. 8. Injury Division, The George Institute for Global Health, Sydney, Australia.
Abstract
INTRODUCTION: The aim of this study was to describe post-discharge outcomes, and determine predictors of 3 and 6 months health status outcomes in a population of trauma patients at an inner city major trauma centre. METHODS: This was a prospective cohort study of adult trauma patients admitted to this hospital with 3 and 6 months post-discharge outcomes assessment. Outcome measures were the Physical Component Scores (PCS) and Mental Component Scores (MCS) of the Short Form 12, EQ-5D, and return to work (in any capacity) if working prior to injury. Repeated measures mixed models and generalised estimating equation models were used to determine predictors of outcomes at 3 and 6 months. RESULTS: One hundred and seventy-nine patients were followed up. Patients with lower limb injuries reported lower mean PCS scores between 3 and 6 months (coefficient -4.21, 95 % CI -7.58, -0.85) than those without lower limb injuries. Patients involved in pedestrian incidents or assaults and those with pre-existing mental health diagnoses reported lower mean MCS scores. In adjusted models upper limb injuries were associated with reduced odds of return to work at 3 and 6 months (OR 0.20, 95 % CI 0.07, 0.57) compared to those without upper limb injuries. DISCUSSION: Predictors of poorer physical health status were lower limb injuries and predictors of mental health were related to the mechanism of injury and past mental health. Increasing injury severity score and upper limb injuries were the only predictors of reduced return to work. The results provide insights into the feasibility of routine post-discharge follow-up at a trauma service level.
INTRODUCTION: The aim of this study was to describe post-discharge outcomes, and determine predictors of 3 and 6 months health status outcomes in a population of traumapatients at an inner city major trauma centre. METHODS: This was a prospective cohort study of adult traumapatients admitted to this hospital with 3 and 6 months post-discharge outcomes assessment. Outcome measures were the Physical Component Scores (PCS) and Mental Component Scores (MCS) of the Short Form 12, EQ-5D, and return to work (in any capacity) if working prior to injury. Repeated measures mixed models and generalised estimating equation models were used to determine predictors of outcomes at 3 and 6 months. RESULTS: One hundred and seventy-nine patients were followed up. Patients with lower limb injuries reported lower mean PCS scores between 3 and 6 months (coefficient -4.21, 95 % CI -7.58, -0.85) than those without lower limb injuries. Patients involved in pedestrian incidents or assaults and those with pre-existing mental health diagnoses reported lower mean MCS scores. In adjusted models upper limb injuries were associated with reduced odds of return to work at 3 and 6 months (OR 0.20, 95 % CI 0.07, 0.57) compared to those without upper limb injuries. DISCUSSION: Predictors of poorer physical health status were lower limb injuries and predictors of mental health were related to the mechanism of injury and past mental health. Increasing injury severity score and upper limb injuries were the only predictors of reduced return to work. The results provide insights into the feasibility of routine post-discharge follow-up at a trauma service level.
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