Long term outcomes 12 years after major trauma.
OBJECTIVE
To provide long term population-based follow up on major trauma patients 12 years after injury.


METHODS
This cohort study was based on a stratified random sample of patients with an injury severity score greater than 15 who reached hospital alive in 1990-1991. The patient details were used to trace them and to assess the patients' recovery, using endpoints of current employment status and any current physical or mental health problems. A Glasgow outcome score was allocated on the basis of these replies.


RESULTS
Of 239 patients included in the original tranche, (23.2/100,000), 165 (16/100,000) survived to hospital discharge. 138 (86%) were traced, and 4 patients had left the country. Patients mean age was 34 (range 2-93). The male to female ratio was approximately 3:1. Twenty-one patients had died since discharge, due to unrelated illnesses. One hundred and five (76%) were living independently (GOS 4 and 5). Eleven patients (8%) were severely disabled, requiring assistance with activities of daily living. One patient remains in a persistent vegetative state. Return to work rates for those working at time of injury (and who remain of employable age) was 90%. The unemployment rate in the study population who are of working age was 34% (pre-injury rate 13%). The unemployment rate for those injured before their 17th birthday is currently 52%.


CONCLUSIONS
We now have 12 year population based outcome data for major trauma. Despite major injury, 90% of long term survivors are living independently, with 90% returning to work. There is a trend towards higher unemployment when injured in childhood.
Redmill
Duncan A
DA
Emergency Medicine, Yorkshire Deanery, UK. dredmill@doctors.org.uk
McIlwee
Alistair
A
McNicholl
Brian
B
Templeton
Claire
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D023261:Glasgow Outcome Scale; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D009660:Northern Ireland; D016896:Treatment Outcome