T H Rainer1, K K C Hung2, J H H Yeung2, S K C Cheung3, Y K Leung3, L Y Leung3, W B Goggins4, H F Ho5, C W Kam6, N K Cheung2, C A Graham7. 1. Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; School of Medicine, Cardiff University, United Kingdom. 2. Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong. 3. Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong. 4. JC School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong. 5. Accident and Emergency Department, Queen Elizabeth Hospital, Hong Kong. 6. Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Accident and Emergency Department, Tuen Mun Hospital, Hong Kong. 7. Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Hong Kong; Trauma & Emergency Centre, Prince of Wales Hospital, Hong Kong. Electronic address: cagraham@cuhk.edu.hk.
Abstract
BACKGROUND: Trauma care systems in Asia have been developing in recent years, but there has been little long-term outcome data from injured survivors. This study aims to evaluate the trajectory of functional outcome and health status up to five years after moderate to major trauma in Hong Kong. METHODS: We report the five year follow up results of a multicentre, prospective cohort from the trauma registries of three regional trauma centres in Hong Kong. The original cohort recruited 400 adult trauma patients with ISS ≥ 9. Telephone follow up was conducted longitudinally at seven time points, and the extended Glasgow Outcome Scale (GOSE) and Short-Form 36 (SF36) were tracked. RESULTS: 119 out of 309 surviving patients (39%) completed follow up after 5 years. The trajectory of GOSE, PCS and MCS showed gradual improvements over the seven time points. 56/119 (47.1%) patients reported a GOSE = 8 (upper good recovery), and the mean PCS and MCS was 47.8 (95% CI 45.8, 49.9) and 55.8 (95% CI 54.1, 57.5) respectively at five years. Univariate logistic regression showed change in PCS - baseline to 1 year and 1 year to 2 years, and change in MCS - baseline to 1 year were associated with GOSE = 8 at 5 years. Linear mixed effects model showed differences in PCS and MCS were greatest between 1-month and 6-month follow up. CONCLUSIONS: After injury, the most rapid improvement in PCS and MCS occurred in the first six to 12 months, but further recovery was still evident for MCS in patients aged under 65 years for up to five years.
BACKGROUND:Trauma care systems in Asia have been developing in recent years, but there has been little long-term outcome data from injured survivors. This study aims to evaluate the trajectory of functional outcome and health status up to five years after moderate to major trauma in Hong Kong. METHODS: We report the five year follow up results of a multicentre, prospective cohort from the trauma registries of three regional trauma centres in Hong Kong. The original cohort recruited 400 adult traumapatients with ISS ≥ 9. Telephone follow up was conducted longitudinally at seven time points, and the extended Glasgow Outcome Scale (GOSE) and Short-Form 36 (SF36) were tracked. RESULTS: 119 out of 309 surviving patients (39%) completed follow up after 5 years. The trajectory of GOSE, PCS and MCS showed gradual improvements over the seven time points. 56/119 (47.1%) patients reported a GOSE = 8 (upper good recovery), and the mean PCS and MCS was 47.8 (95% CI 45.8, 49.9) and 55.8 (95% CI 54.1, 57.5) respectively at five years. Univariate logistic regression showed change in PCS - baseline to 1 year and 1 year to 2 years, and change in MCS - baseline to 1 year were associated with GOSE = 8 at 5 years. Linear mixed effects model showed differences in PCS and MCS were greatest between 1-month and 6-month follow up. CONCLUSIONS: After injury, the most rapid improvement in PCS and MCS occurred in the first six to 12 months, but further recovery was still evident for MCS in patients aged under 65 years for up to five years.
Authors: Kevin Kei Ching Hung; Ling Yan Leung; Janice Hiu Hung Yeung; Tak Kan Wong; Tsz Ying Yiu; Yuk Ki Leung; Lily Po Shan Chan; John Kit Shing Wong; Melissa Po Shan Leung; William Bernard Goggins; David Yuen Chung Chan; Chun Tat Lui; Wai Kuen Ng; Hiu Fai Ho; Chi Hung Cheng; Nai Kwong Cheung; Colin Alexander Graham Journal: Eur J Trauma Emerg Surg Date: 2022-02-17 Impact factor: 2.374
Authors: Kevin K C Hung; Annette Kifley; Katherine Brown; Jagnoor Jagnoor; Ashley Craig; Belinda Gabbe; Sarah Derrett; Michael Dinh; Bamini Gopinath; Ian D Cameron Journal: BMC Public Health Date: 2021-03-27 Impact factor: 3.295
Authors: Kevin K C Hung; Annette Kifley; Katherine Brown; Jagnoor Jagnoor; Ashley Craig; Belinda Gabbe; Sarah Derrett; Alex Collie; Michael Dinh; Bamini Gopinath; Ian D Cameron Journal: J Rehabil Med Date: 2022-07-05 Impact factor: 3.959