Outcome after musculoskeletal trauma treated in a regional hospital.
BACKGROUND
Trauma remains the leading cause of death and morbidity in the under-35-year-old population. The majority of reports assessing outcome after trauma emanate from North American Level I trauma centers. We sought to examine outcome after trauma treated in an Irish regional unit.


METHODS
All patients admitted over a 1-year period with an Injury Severity Score > or =9 were evaluated and 61 patients recruited to the study. Demographic data, medical history, and details of the mechanism and pattern of injury and treatment were collected. Patients' functional outcome was assessed using the Sickness Impact Profile (SIP), duration of hospital stay, and return to work.


RESULTS
Significant residual disability was noted (mean SIP 13.63+/-14.60). Thirty-seven percent of patients had not returned to work despite a mean follow-up of 18.36 months. Factors associated with a poor outcome include increasing age, a blue-collar occupation, lower limb fractures, comorbid conditions, and the presence of complications.


CONCLUSIONS
Optimizing primary care of the trauma victim may help to minimize consequent morbidity. A small group of patients suffer permanent disability, and vocational retraining opportunities should be made available to them.
Morris
S
S
Department of Orthopaedic Surgery, Merlin Park Regional Hospital, Galway, Ireland.
Lenihan
B
B
Duddy
L
L
O'Sullivan
M
M
D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004638:Emergency Treatment / Q000592:standards*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007494:Ireland; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009141:Musculoskeletal System / Q000293:injuries*; D012041:Regional Medical Programs / Q000592:standards; D018434:Sickness Impact Profile; D014193:Trauma Centers / Q000592:standards* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000145:classification / Q000453:epidemiology / Q000628:therapy*