title: Rehabilitation outcomes for orthopaedic trauma individuals as measured by the INTERMED.
abstract: OBJECTIVE
  Bio-psychosocial characteristics of patients after orthopaedic traumas may be a strong predictor of poor outcome. The objective of this prospective study was to assess whether the INTERMED, a measure of bio-psychosocial complexity, identifies complex inpatients during rehabilitation including vocational aspects with a poor outcome 1 year after discharge.
  
  
  METHODS
  At entry, the INTERMED scores of 118 inpatients were used to assign patients to the high or low complexity group. A questionnaire evaluated 1 year after discharge whether patients: (1) returned to work, (2) still have therapies, (3) take psychoactive drugs, (4) take medication against pain and (5) were satisfied with vocational therapy. Univariate logistic regressions identified which variables predict INTERMED case complexity during hospitalisation as well as predictors (i.e. INTERMED case complexity, French as preferred language, duration of the disability, accident at work, work qualification, severity of the injury, psychiatric co-morbidities, pain) of the five measured outcomes 1 year after discharge.
  
  
  RESULTS
  During hospitalisation, the high complexity group was associated with a high prevalence of psychiatric co-morbidities, a higher level of pain and a weaker perception of treatment effects. One year after discharge, the INTERMED was the sole variable to predict all outcomes.
  
  
  CONCLUSIONS
  The INTERMED identifies complex patients during vocational rehabilitation after orthopaedic trauma and is a good predictor of poor outcome 1 year after discharge.
authors.affiliation: Clinique Romande de Réadaptation Suvacare, Case Postale 352 Av. Grand Champsec 90, CH-1950 Sion, Switzerland. francois.luthi@crr-suva.ch
authors.forename: François
authors.initials: F
authors.lastname: Luthi
authors.forename: Friedrich
authors.initials: F
authors.lastname: Stiefel
authors.forename: Charles
authors.initials: C
authors.lastname: Gobelet
authors.forename: Gilles
authors.initials: G
authors.lastname: Rivier
authors.forename: Olivier
authors.initials: O
authors.lastname: Deriaz
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009141:Musculoskeletal System / Q000293:injuries*; D010147:Pain Measurement; D011446:Prospective Studies; D012050:Rehabilitation, Vocational; D012944:Social Support; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000453:epidemiology / Q000534:rehabilitation*; D055815:Young Adult