title: The impact of trauma mechanism on outcome: a follow-up study on health-related quality of life after major trauma.
abstract: OBJECTIVE
  To relate the trauma mechanism in a trauma population to health-related quality of life outcomes and mortality rates.
  
  
  METHODS
  A consecutive series of patients (>15 years old) with major injuries [Injury Severity Score (ISS) ≥10] treated during a 2-year period at a general hospital in a city area were included (n = 458). Baseline data were collected from medical records, and patients were followed up 12 months post injury. Outcome was measured by health-related quality of life (HRQoL) according to the SF-36 and musculoskeletal function according to the short musculoskeletal function assessment (SMFA). Mortality rates were collected during 7 years.
  
  
  RESULTS
  Of all patients, 86.9% had an unintentional injury, 4.4% had a self-inflicted injury, and 8.7% had been assaulted. The mortality rate during the acute phase and at 7 years post trauma did not differ between the groups with different trauma mechanisms. At 12 months, patients with unintentional injuries and assault victims had SF-36 ratings comparable to the general population, while patients with self-inflicted injuries had worse ratings in all SF-36 domains except physical function and general health. There were no differences between the groups regarding SMFA results.
  
  
  CONCLUSIONS
  Even though the follow-up rate was only 53%, this study showed that, at 12 months, patients with self-inflicted injuries had significantly lower HRQoL ratings. There was no difference in mortality with regard to trauma mechanism. Cooperation between emergency service and psychiatric care early in the acute phase could provide a golden opportunity to reach this patient group.
authors.affiliation: Section of Internal Medicine, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, 118 83, Stockholm, Sweden. katarina.bilen@sodersjukhuset.se.|Section of Emergency Medicine, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. katarina.bilen@sodersjukhuset.se.
authors.forename: Katarina
authors.initials: K
authors.lastname: Bilén
authors.affiliation: Section of Orthopedic Surgery, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Sari
authors.initials: S
authors.lastname: Ponzer
authors.affiliation: Section of Emergency Medicine, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Maaret
authors.initials: M
authors.lastname: Castrén
authors.affiliation: Section of Biostatistics, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Pettersson
authors.affiliation: Section of Orthopedic Surgery, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Carin
authors.initials: C
authors.lastname: Ottosson
keywords: HRQoL; Major trauma; Mortality; Mortality rate; Quality of life; Self-inflicted injuries
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