Kevin Kei Ching Hung1,2,3, Timothy H Rainer1,4, Janice Hiu Hung Yeung1,2, Catherine Cheung1, Yuki Leung1, Ling Yan Leung1, Marc Chong3, Hiu Fai Ho5, Kwok Leung Tsui6, Nai Kwong Cheung1,2, Colin Graham7,8,9. 1. Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. 2. Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. 3. School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong. 4. Emergency Medicine Unit, University of Hong Kong, Pok Fu Lam, Hong Kong. 5. Accident and Emergency Department, Queen Elizabeth Hospital, Yau Ma Tei, Hong Kong. 6. Trauma Committee, New Territory West Cluster, Hospital Authority, Kowloon, Hong Kong. 7. Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. cagraham@cuhk.edu.hk. 8. Trauma & Emergency Centre, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. cagraham@cuhk.edu.hk. 9. School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong. cagraham@cuhk.edu.hk.
Abstract
PURPOSE: The purpose was to investigate long-term health impacts of trauma and the aim was to describe the functional outcome and health status up to 7 years after trauma. METHODS: We conducted a prospective, multi-centre cohort study of adult trauma patients admitted to three regional trauma centres with moderate or major trauma (ISS ≥ 9) in Hong Kong (HK). Patients were followed up at regular time points (1, 6 months and 1, 2, 3, 4, 5, 6, and 7 years) by telephone using extended Glasgow Outcome Scale (GOSE) and the Short-Form 36 (SF36). Observed annual mortality rate was compared with the expected mortality rate estimated using the HK population cohort. Linear mixed model (LMM) analyses examined the changes in SF36 with subgroups of age ≥ 65 years, ISS > 15, and GOSE ≥ 5 over time. RESULTS: At 7 years, 115 patients had died and 48% (138/285) of the survivors responded. The annual mortality rate (AMR) of the trauma cohort was consistently higher than the expected mortality rate from the general population. Forty-one percent of respondents had upper good recovery (GOSE = 8) at 7 years. Seven-year mean PCS and MCS were 45.06 and 52.06, respectively. LMM showed PCS improved over time in patients aged < 65 years and with baseline GOSE ≥ 5, and the MCS improved over time with baseline GOSE ≥ 5. Higher mortality rate, limited functional recovery and worse physical health status persisted up to 7 years post-injury. CONCLUSION: Long-term mortality and morbidity should be monitored for Asian trauma centre patients to understand the impact of trauma beyond hospital discharge.
PURPOSE: The purpose was to investigate long-term health impacts of trauma and the aim was to describe the functional outcome and health status up to 7 years after trauma. METHODS: We conducted a prospective, multi-centre cohort study of adult trauma patients admitted to three regional trauma centres with moderate or major trauma (ISS ≥ 9) in Hong Kong (HK). Patients were followed up at regular time points (1, 6 months and 1, 2, 3, 4, 5, 6, and 7 years) by telephone using extended Glasgow Outcome Scale (GOSE) and the Short-Form 36 (SF36). Observed annual mortality rate was compared with the expected mortality rate estimated using the HK population cohort. Linear mixed model (LMM) analyses examined the changes in SF36 with subgroups of age ≥ 65 years, ISS > 15, and GOSE ≥ 5 over time. RESULTS: At 7 years, 115 patients had died and 48% (138/285) of the survivors responded. The annual mortality rate (AMR) of the trauma cohort was consistently higher than the expected mortality rate from the general population. Forty-one percent of respondents had upper good recovery (GOSE = 8) at 7 years. Seven-year mean PCS and MCS were 45.06 and 52.06, respectively. LMM showed PCS improved over time in patients aged < 65 years and with baseline GOSE ≥ 5, and the MCS improved over time with baseline GOSE ≥ 5. Higher mortality rate, limited functional recovery and worse physical health status persisted up to 7 years post-injury. CONCLUSION: Long-term mortality and morbidity should be monitored for Asian trauma centre patients to understand the impact of trauma beyond hospital discharge.
Authors: Giana H Davidson; Christian A Hamlat; Frederick P Rivara; Thomas D Koepsell; Gregory J Jurkovich; Saman Arbabi Journal: JAMA Date: 2011-03-09 Impact factor: 56.272
Authors: Hadley K H Wesson; Nonkululeko Boikhutso; Abdulgafoor M Bachani; Karen J Hofman; Adnan A Hyder Journal: Health Policy Plan Date: 2013-10-04 Impact factor: 3.344
Authors: Belinda J Gabbe; Pam M Simpson; Peter A Cameron; Jennie Ponsford; Ronan A Lyons; Alex Collie; Mark Fitzgerald; Rodney Judson; Warwick J Teague; Sandra Braaf; Andrew Nunn; Shanthi Ameratunga; James E Harrison Journal: PLoS Med Date: 2017-07-05 Impact factor: 11.069
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