title: Socio-economic outcome after blunt orthopaedic trauma: Implications on injury prevention.
abstract: BACKGROUND
  Several large studies have identified factors associated with long-term outcome after orthopaedic injuries. However, long-term social and economic implications have not been published so far. The aim of this investigation is to study the long-term socio-economic consequences of patients sustaining severe trauma.
  
  
  METHODS
  Patients treated at a level one trauma center were invited for a follow-up (at least 10 years) examination. There were 637 patients who responded and were examined. Inclusion criteria included injury severity score (ISS) ≥ 16 points, presence of lower and upper extremity fractures, and age between 3 and 60 years. Exclusion criteria included the presence of amputations and paraplegia. The socio-economic outcome was evaluated in three age groups: group I (< 18 years), group II (19 - 50 years), and group III (> 50 years). The following parameters were analyzed using a standardized questionnaire: financial losses, net income losses, pension precaution losses, need for a bank loan, and the decrease in number of friends.
  
  
  RESULTS
  510 patients matched all study criteria, and breakdown of groups were as follows: 140 patients in group I, 341 patients in group II, and 29 patients in group III. Financial losses were reported in all age groups (20%-44%). Younger patients (group I) were associated with less income losses when compared with other groups (p < 0.05). Financial deterioration was more frequently reported in age group II (p < 0.05). Social consequences (number of friends decreased) were predominantly stated in patients younger than 18 years old (p < 0.05).
  
  
  CONCLUSIONS
  Economic consequences are reported by polytraumatized patients even ten or more years after injury. Financial losses appear to be common in patients between 19 and 50 years. In contrast, social deprivation appears to be most pronounced in the younger age groups. Early socio-economic support and measures of injury prevention should focus on these specific age groups.
authors.affiliation: University of Aachen Medical Center, Department of Orthopaedic Trauma, Pauwelsstraße 30, 52074 Aachen, Germany. romanpfeifer@aol.com.
authors.forename: Roman
authors.initials: R
authors.lastname: Pfeifer
authors.forename: Philipp
authors.initials: P
authors.lastname: Lichte
authors.forename: Boris A
authors.initials: BA
authors.lastname: Zelle
authors.forename: Nicola-Alexander
authors.initials: NA
authors.lastname: Sittaro
authors.forename: Anna
authors.initials: A
authors.lastname: Zilkens
authors.forename: Jason R
authors.initials: JR
authors.lastname: Kaneshige
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Pape