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Title: Return to Work and Functional Outcomes After Major Trauma: Who Recovers, When, and How Well?
Epworth Authors: Ponsford, Jennie
Other Authors: Gabbe, Belinda
Simpson, Pamela
Harrison, James
Lyons, Ronan
Ameratunga, Shanthi
Fitzgerald, Mark
Judson, Rodney
Collie, Alex
Cameron, Peter
Keywords: Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Victoria, Australia
Long-term Outcome
Major Trauma
Return to Work
Quality of Life
Wounds and Injuries
Injury-Related Mortality
Issue Date: Apr-2016
Publisher: Wolters Kluwer
Citation: Ann Surg. 2016 Apr;263(4):623-32.
Abstract: OBJECTIVE: To describe the long-term outcomes of major trauma patients and factors associated with the rate of recovery. BACKGROUND: As injury-related mortality decreases, there is increased focus on improving the quality of survival and reducing nonfatal injury burden. METHODS: Adult major trauma survivors to discharge, injured between July 2007 and June 2012 in Victoria, Australia, were followed up at 6, 12, and 24 months after injury to measure function (Glasgow Outcome Scale-Extended) and return to work/study. Random-effects regression models were fitted to identify predictors of outcome and differences in the rate of change in each outcome between patient subgroups. RESULTS: Among the 8844 survivors, 8128 (92%) were followed up. Also, 23% had achieved a good functional recovery, and 70% had returned to work/study at 24 months. The adjusted odds of reporting better function at 12 months was 27% (adjusted odds ratio 1.27, 95% confidence interval [CI] 1.19-1.36) higher compared with 6 months, and 9% (adjusted odds ratio 1.09, 95% CI, 1.02-1.17) higher at 24 months compared with 12 months. The adjusted relative risk (RR) of returning to work was 14% higher at 12 months compared with 6 months (adjusted RR 1.14, 95% CI, 1.12-1.16) and 8% (adjusted RR 1.08, 95% CI, 1.06-1.10) higher at 24 months compared with 12 months. CONCLUSIONS: Improvement in outcomes over the study period was observed, although ongoing disability was common at 24 months. Recovery trajectories differed by patient characteristics, providing valuable information for informing prognostication and service planning, and improving our understanding of the burden of nonfatal injury.
DOI: 10.1097/SLA.0000000000001564
PubMed URL:
ISSN: 0003-4932
Journal Title: Annals of Surgery
Type: Journal Article
Affiliated Organisations: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
The Farr Institute Centre for Improvement of Population Health through E-records Research, College of Medicine, Swansea University, Swansea, UK
Research Centre for Injury Studies, Flinders University, Adelaide, South Australia, Australia
Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand
Trauma Service, The Alfred, Melbourne, Australia
Department of Surgery, Monash University, Melbourne, Australia
Trauma Service, Royal Melbourne Hospital, Parkville, Australia
Institute for Safety, Compensation and Recovery Research, Monash University, Melbourne, Australia
Emergency and Trauma Centre, The Alfred, Melbourne, Australia
Type of Clinical Study or Trial: Retrospective studies
Appears in Collections:Rehabilitation

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