title: Physical effects of trauma and the psychological consequences of preexisting diseases account for a significant portion of the health-related quality of life patterns of former trauma patients.
abstract: BACKGROUND
  Health-related quality of life (HRQoL) is known to be significantly affected in former trauma patients. However, the underlying factors that lead to this outcome are largely unknown. In former intensive care unit (ICU) patients, it has been recognized that preexisting disease is the most important factor for the long-term HRQoL. The aim of this study was to investigate HRQoL up to2 years after trauma and to examine the contribution of the trauma-specific, ICU-related, sociodemographic factors together with the effects of preexisting disease, and further to make a comparison with a large general population.
  
  
  METHODS
  A prospective 2-year multicenter study in Sweden of 108 injured patients. By mailed questionnaires, HRQoL was assessed at 6 months,12 months, and 24 months after the stay in ICU by Short Form (SF)-36, and information of preexisting disease was collected from the national hospital database. ICU-related factors were obtained from the local ICU database. Comorbidity and HRQoL (SF-36) was also examined in the reference group, a random sample of 10,000 inhabitants in the uptake area of the hospitals.
  
  
  RESULTS
  For the trauma patients, there was a marked and early decrease in the physical dimensions of the SF-36 (role limitations due to physical problems and bodily pain). This decrease improved rapidly and was almost normalized after 24 months. In parallel, there were extensive decreases in the psychologic dimensions (vitality, social functioning, role limitations due to emotional problems,and mental health) of the SF-36 when comparisons were made with the general reference population.
  
  
  CONCLUSIONS
  The new and important finding in this study is that the trauma population seems to have a trauma-specific HRQoL outcome pattern.First, there is a large and significant decrease in the physical dimensions of the SF-36, which is due to musculoskeletal effects and pain secondary to the trauma. This normalizes within 2 years, whereas the overall decrease in HRQoL remains and most importantly it is seen mainly in the psychologic dimensions and it is due to preexisting diseases.
authors.affiliation: Departments of Intensive Care, Medicine and Health Sciences, Faculty of Health Sciences, University Hospital, Linköping, Sweden. lotti.orvelius@lio.se
authors.forename: Lotti
authors.initials: L
authors.lastname: Orwelius
authors.forename: Max
authors.initials: M
authors.lastname: Bergkvist
authors.forename: Anders
authors.initials: A
authors.lastname: Nordlund
authors.forename: Eva
authors.initials: E
authors.lastname: Simonsson
authors.forename: Peter
authors.initials: P
authors.lastname: Nordlund
authors.forename: Carl
authors.initials: C
authors.lastname: Bäckman
authors.forename: Folke
authors.initials: F
authors.lastname: Sjöberg
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013548:Sweden; D014947:Wounds and Injuries / Q000503:physiopathology* / Q000523:psychology*