title: Evaluating time points for measuring recovery after major trauma in adults.
abstract: OBJECTIVE
  To evaluate recovery after major trauma over a 24-month time frame.
  
  
  BACKGROUND
  Measuring disability after injury is seen as increasingly important but requires knowledge not only of the measures that should be implemented but also of the critical time points for follow-up.
  
  
  METHODS
  Six hundred sixty-two adult major trauma patients from 2 level 1 trauma centers (October 2006 to March 2007) were followed up by telephone at 6-, 12-, 18-, and 24 months after injury. SF-12, Glasgow Outcome Scale-Extended (GOS-E), pain scores, and return to work (RTW) were collected. Multilevel mixed-effects regression models were fitted to analyze change in outcomes over time.
  
  
  RESULTS
  Six hundred seventeen (93%) were followed up for at least 1 time point. Functional recovery (GOS-E = 8) [odds ratio (OR) 3.1, 95% CI: 1.9, 5.0] and RTW (OR 2.4, 95% CI: 1.4, 4.0) improved, and physical health (PCS-12) scores were better (mean difference 1.9, 95% CI: 0.9, 2.9), from 6 to 12 months after injury, but changed little from 12 months. Pain scores were unchanged from 6 to 12 months but were higher at 18 months than at 12 months (OR 1.8, 95% CI: 1.2, 2.8). SF-12 mental health (MCS-12) scores decreased until 18 months but improved from 18 to 24 months (mean difference 1.5, 95% CI: 0.2, 2.8). The rate of recovery differed by injury group and age.
  
  
  CONCLUSIONS
  Different patterns of recovery were evident for each outcome, and there was a variation in the rate of recovery for some subgroups. The selection of time points for follow-up requires consideration of the outcome measurements of interest and the population being studied.
authors: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. belinda.gabbe@monash.edu
authors: Belinda J
authors: BJ
authors: Gabbe
authors: Pam M
authors: PM
authors: Simpson
authors: Ann M
authors: AM
authors: Sutherland
authors: Rory
authors: R
authors: Wolfe
authors: Ronan A
authors: RA
authors: Lyons
authors: Peter A
authors: PA
authors: Cameron
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011788:Quality of Life; D020127:Recovery of Function; D012042:Registries; D012044:Regression Analysis; D062707:Return to Work; D013997:Time Factors; D014739:Victoria; D014947:Wounds and Injuries / Q000534:rehabilitation*; D055815:Young Adult