Predictors of general health after major trauma.
BACKGROUND
Traumatic injury is a leading contributor to the global burden of disease, yet there has been little research on possible predictors of general health after major trauma. This study aims to explore possible predictors of general health after major physical trauma.


METHODS
A survey was performed of 731 surviving consecutive adult patients presenting to a major trauma center with accidental major trauma, between 1 year and 5 years postinjury. Data pertaining to general patient factors, injury severity factors, socioeconomic factors, and claim-related factors were abstracted from the hospital trauma database and the questionnaire. Multiple linear regression was used to develop a predictive model for the main outcome, the physical and mental component summaries of the SF-36 General Health Survey.


RESULTS
One hundred and forty nine patients were excluded, 93 refused to participate, and 134 did not respond, leaving 355 participants. On multivariate analysis, better physical health was significantly associated with increasing time since the injury and lower Injury Severity Scores (p = 0.03 and 0.02, respectively). Having a settled compensation claim, having an unsettled compensation claim, and using a lawyer were independently associated with poor physical health (p = 0.02, 0.006, and <0.0001, respectively). Measures of injury severity or socioeconomic status were not associated with mental health. However, having an unsettled compensation claim was strongly associated with poor mental health (p < 0.0001).


CONCLUSIONS
General health after major physical trauma is more strongly associated with factors relating to compensation than with the severity of the injury. Processes involved with claiming compensation after major trauma may contribute to poor patient outcomes.
Harris
Ian A
IA
Orthopaedic Department, Liverpool Hospital, Liverpool, NSW, Australia. iaharris@optushome.com.au
Young
Jane M
JM
Rae
Hamish
H
Jalaludin
Bin B
BB
Solomon
Michael J
MJ
D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001315:Australia; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D015601:Injury Severity Score; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011788:Quality of Life; D018434:Sickness Impact Profile; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D011795:Surveys and Questionnaires; D017741:Survivors; D014942:Workers' Compensation / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*