title: Long-term outcomes of major trauma without head injury in the West of Scotland: pilot case-control study.
abstract: The aim of this study was to identify the outcomes of survivors of blunt major trauma (without head injury) 2 years or more following injury. The study uses a case-control design, is set in the West of Scotland and includes trauma patients treated in Greater Glasgow NHS Board hospitals. Participants consisted of patients who had sustained major trauma (injury severity score >15) with little or no head injury at least 2 years before assessment, identified from the Scottish Trauma Audit Group database, and age and sex-matched controls nominated by the index case's general practitioner. Nineteen cases and seven controls completed the study from 223 potential cases and 39 potential controls. Participants and non-participants had comparable injury severity score, probability of survival (Ps) and length of stay. American Medical Association impairment scores show survivors were more impaired than controls (25.9 vs 7.4%, P=0.043). No differences were observed in Functional Independence Measure (FIM) or Community Integration Questionnaire (CIQ) scores, although a type II error is possible. Short-form 36 (SF36) Physical Component Summary (PCS) scores of survivors showed no difference compared with controls although survivors' PCS scores were below UK and US means (P=0.008). SF36 Mental Component Summary (MCS) scores of survivors were below those of controls (45.07 vs 56.65, P=0.004) and normal values of the UK population (P=0.036). No differences in work status were noted, but small sample sizes were used. Non-head-injured survivors of major trauma in the West of Scotland have poorer health status (SF36), physically and mentally, than the UK population. They have greater impairment, but have an employment status comparable to that of the controls. The lack of differences in FIM and CIQ scores between survivors and controls may be due to small sample sizes.
authors.affiliation: Accident and Emergency Medicine Academic Unit, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong SAR. cagraham@cuhk.edu.hk
authors.forename: Colin A
authors.initials: CA
authors.lastname: Graham
authors.forename: Malcolm W G
authors.initials: MW
authors.lastname: Gordon
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Roy
authors.forename: Philip W
authors.initials: PW
authors.lastname: Hanlon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004185:Disability Evaluation; D004651:Employment / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D001523:Mental Disorders / Q000209:etiology; D008875:Middle Aged; D010865:Pilot Projects; D011379:Prognosis; D012606:Scotland; D017741:Survivors; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000534:rehabilitation