Trajectory subtypes after injury and patient-centered outcomes

Area of Science:

• Trauma research
• Patient outcomes
• Health trajectories

Background:

• Patient-centered outcomes emphasize understanding recovery after injury.
• Characterizing recovery trajectories after non-neurologic injury is needed.

Purpose of the Study:

• To identify and describe distinct recovery trajectory subtypes following non-neurologic injury.

Main Methods:

• Prospective observational cohort of 500 adults with Injury Severity Score > 10.
• Short Form-36 (SF-36) administered at baseline and 1, 2, 4, 12 months post-injury.
• Group-based trajectory modeling used for Physical Composite Score (PCS) and Mental Composite Score (MCS).

Main Results:

• Identified 3 Physical Composite Score (PCS) trajectories: no improvement, delayed improvement, and rapid recovery.
• Identified 5 Mental Composite Score (MCS) trajectories: persistently low, no recovery, initial decrease with recovery, steady decline, and consistently high.
• Prevalence of PCS trajectories: 10.4% (no improvement), 65.6% (delayed improvement), 24.1% (rapid recovery).
• Prevalence of MCS trajectories: 9.4% (persistently low), 14.4% (no recovery), 22.7% (initial decrease with recovery), 19.1% (steady decline), 34.3% (consistently high).

Conclusions:

• Recovery from non-neurologic injury is heterogeneous, manifesting in multiple distinct trajectories.
• Findings have implications for designing patient-centered clinical trials.
• Identified trajectories can inform the development of patient-specific interventions to optimize recovery outcomes.