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Title: Factors influencing outcome after orthopedic trauma.
Epworth Authors: Ponsford, Jennie
Hill, Bridget
Other Authors: Bahar-Fuchs, Alex
Karamitsios, M
Keywords: Pain Measurement
Stress Disorders, Post-Traumatic
Post-Traumatic Stress Disorders
Recovery of Function
Outcome Assessment, Patient
Patient Outcome Assessment
International Classification of Functioning, Disability and Health
Disability Evaluation
Social Adjustment
Adjustment, Social
Adaptation, Psychological
Adjustment, Psychological
Psychological Adaptation
Psychological Adjustment
Health Surveys
Data Aggregation
Chronic Pain
Pain, Chronic
People with Disabilities
Disabled Persons
Monash-Epworth Rehabilitation Research Centre, Richmond, Victoria, Australia.
Issue Date: Apr-2008
Publisher: Wolters Kluwer
Citation: Journal of Trauma 2008 Apr;64(4):1001-9
Abstract: BACKGROUND: Some recent studies have suggested that certain types of orthopaedic trauma result in ongoing disability and that factors other than injury severity or location may influence outcome. This study aimed to evaluate outcome 12 months and 2 years after severe orthopaedic trauma, as measured on the Short Form (SF)-36 Health Survey, relative to a control group, to examine change over time and to examine which demographic, injury-related and psychological factors are associated with persisting disability. METHODS: One hundred thirteen orthopaedic trauma patients, recruited during rehabilitation, and 61 demographically similar uninjured controls were followed up at 1 and 2 years post injury. Measures included the SF-36 Health Survey, Symptom Checklist-90-R, Brief Pain Inventory, Hospital Anxiety and Depression Scales, and Posttraumatic Stress Disorder Checklist-Specific. RESULTS: Results indicated presence of significant ongoing disability in all SF-36 physical and mental health domains, significant ongoing psychological adjustment problems, including posttraumatic stress disorder (PTSD) symptoms, and pain, with little or no improvement between 1 and 2 years post injury. The presence of ongoing pain, anxiety, depression or PTSD symptoms were the strongest predictors of outcome on most variables, with older age also contributing to negative outcomes. Injury severity and type did not predict outcome, although those with lower limb fractures had greater pain and poorer physical outcomes that those with fractures in other locations. CONCLUSIONS: This study has highlighted pain and PTSD symptoms as frequent and disabling factors after orthopaedic trauma. There is clearly a need to focus on alleviating these problems as part of the rehabilitation process.
DOI: 10.1097/TA.0b013e31809fec16
PubMed URL:
ISSN: 0022-5282
Journal Title: Journal of Trauma-Injury Infection & Critical Care
Type: Journal Article
Affiliated Organisations: Department of Psychology, Monash University, Melbourne, Victoria, Australia
Type of Clinical Study or Trial: Prospective Cohort Study
Appears in Collections:Mental Health
Pain Management

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