title: Long-term survival and health-related quality of life 6 to 9 years after trauma.
abstract: BACKGROUND
  Trauma systems have improved short-term survival of the severely injured but knowledge on long-term outcome is limited. This study aimed to assess outcome 6 years to 9 years after moderate to severe injury in terms of survival, Health-Related Quality of Life (HRQOL) and employment status.
  
  
  METHODS
  Patients admitted to Aarhus Level I Trauma Center in 1998 to 2000, aged 15 years or more, with an Injury Severity Score (ISS) ≥9 were included. Patients were divided into three groups based on ISS (ISS, 9-15; ISS, 16-24; ISS >24). Survival status was obtained from the Danish Central Person Registry. HRQOL was measured with the Short Form 36 (SF-36) questionnaire, which was mailed to survivors 6 years to 9 years after admission and compared with a matched control group.
  
  
  RESULTS
  Three hundred twenty-two patients were included. Seventy-one percentage were men, median age was 34 years (range, 15-89 years), median ISS was 17 (range, 9-75). In-hospital survival was 85%. After a median of 7.3 years, overall survival was 78%. After hospital discharge, no difference in survival was found between the three patient groups.Sixty-nine percentage of the contacted patients completed the SF-36. Mean SF-36 scores were significantly lower in the patient group than in the control group in all eight SF-36 domains (p < 0.001). Return to employment or education was 52%, whereas 20% of the patients reported to be on early retirement.
  
  
  CONCLUSIONS
  Six years to nine years after traumatic injury, 78% of the patients were alive. HRQOL was significantly lower for injured patients than a matched control group. Twenty percentage of the patients retired early.
authors.affiliation: Trauma Center, Aarhus University Hospital, Aarhus C, Denmark. mikkel.overgaard@dadlnet.dk
authors.forename: Mikkel
authors.initials: M
authors.lastname: Overgaard
authors.forename: Christian Bjerre
authors.initials: CB
authors.lastname: Høyer
authors.forename: Erika Frischknecht
authors.initials: EF
authors.lastname: Christensen
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D004651:Employment; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000401:mortality*; D055815:Young Adult