Disability in young adults following major trauma: 5 year follow up of survivors.
BACKGROUND
Injuries are a major cause of mortality and morbidity in young people. Despite this, the long-term consequences for young survivors of severe injury are relatively unexplored.


METHODS
Population based cohort study involving 5 year post injury structured interview of all cases of major trauma (Injury Severity Score > 15) identified retrospectively for 12 month period (1988 to 1989) within former Yorkshire Health Authority area of the United Kingdom.


RESULTS
125 individuals aged 11-24 years at time of injury were identified. Of these, 109 (87%) were interviewed. Only 20% (95% CI 14-29%) of those interviewed reported no disability. Mean Office of Population Census and Surveys (OPCS) disability score of the remainder was 7.5 (median 5.8, range 0.5 to 19.4). The most commonly encountered areas of disability were behaviour (54%, 95% CI 45-63%), intellectual functioning (39%, 95% CI 31-49%) and locomotion (29%, 95% CI 22-39%). Many respondents reported that their daily lives were adversely affected by their health problems for example, causing problems with work, 54% (95% CI 45-63%), or looking after the home, 28% (95% CI 21-38%). Higher OPCS scores were usually but not always associated with greater impact on daily activities. The burden of caring responsibilities fell largely on informal carers. 51% (95% CI 42-61%) of those interviewed would have liked additional help to cope with their injury and disability.


CONCLUSIONS
The study has revealed significant disability amongst a cohort of young people 5 years post severe injury. Whilst many of these young people were coping well with the consequences of their injuries, others reported continuing problems with the activities of daily life. The factors underpinning the young people's differing experiences and social outcome should be explored.
Evans
Sian A
SA
Nuffield Institute for Health, University of Leeds. sae26@medschl.cam.ac.uk
Airey
Mark C
MC
Chell
Susan M
SM
Connelly
James B
JB
Rigby
Alan S
AS
Tennant
Alan
A
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D017028:Caregivers; D015331:Cohort Studies; D017281:Cost of Illness; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D020377:Self Efficacy; D018434:Sickness Impact Profile; D017741:Survivors / Q000523:psychology; D006113:United Kingdom / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000523:psychology / Q000534:rehabilitation*