title: Posttraumatic disablement: a prospective study of impairment, disability, and handicap.
abstract: This study was designed to evaluate both the frequency and the course of impairments, disabilities, and handicaps resulting from trauma. It was conducted in Aquitaine, France, on a sample of 1005 trauma patients (mean ISS, 10.5 +/- 0.3) in which severe trauma (ISS > 25) was rather overrepresented (169 of 1005). A prospective follow-up of disablement according to the WHO classification was based on medical examinations performed 6 and 12 months after the trauma. Of 664 survivors reviewed at 6 months, the findings were cross tabulated with Injury Severity Score (ISS) and age. There was a good relationship between ISS and the mean length of stay in the hospital (r = 0.46; p < 0.001), the duration of rehabilitation, and the time away from work or school. Out of this sample of 1005 patients with rather major injuries, 73% of the survivors suffered from at least one impairment, with a consistently lower frequency in children whatever the severity. At least one disability was encountered in 52.3% of these patients depending on both ISS and age. Handicap was noted in at least 26% of the cases. Between the sixth month and the end of the first year, the minimal handicap regression was 35.8%, whereas the minimal regression of the disability rate was 19.5%. The best improvement was observed essentially in the low ISS categories. Whereas for minor trauma the course of disablement seems to be fixed 1 year after the injury, such is not the case for severe trauma.
authors: Department d'anesthesie et de réanimation I, Hôpital Pellegrin, Bordeaux, France.
authors: P
authors: P
authors: Maurette
authors: F
authors: F
authors: Masson
authors: V
authors: V
authors: Nicaud
authors: M
authors: M
authors: Cazaugade
authors: B
authors: B
authors: Garros
authors: L
authors: L
authors: Tiret
authors: M
authors: M
authors: Thicoïpe
authors: P
authors: P
authors: Erny
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006233:Persons with Disabilities / Q000145:classification / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D006769:Hospitals, General; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008875:Middle Aged; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D015996:Survival Rate; D013997:Time Factors; D014193:Trauma Centers; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation