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Functional status, age, and long-term survival after trauma.
Allan B Peetz1, Gabriel A Brat2, Jessica Rydingsward3
1Trauma, Surgical Critical Care & Acute Care Surgery, Case Western Reserve University School of Medicine, Boston, MA.
Surgery
|July 5, 2016
Summary
Functional status at hospital discharge significantly impacts long-term survival in trauma survivors. Lower functional status increases mortality risk, while improvement enhances survival.
Area of Science:
- Trauma critical care research
- Patient outcomes and functional status assessment
- Long-term mortality prediction in critical illness
Background:
- The relationship between functional status and long-term outcomes in trauma survivors remains largely uncharacterized.
- Understanding this association is crucial for improving post-discharge care and survival rates.
Purpose of the Study:
- To investigate the association between functional status at hospital discharge and all-cause, post-discharge mortality in adult trauma patients.
- To determine if functional status predicts long-term survival in this population.
Main Methods:
- Observational cohort study of adult trauma intensive care unit survivors (1997-2011).
- Functional status (bed mobility, transfers, gait) assessed at hospital discharge.
- Multivariable logistic regression used to estimate adjusted odds ratios for mortality.
Main Results:
- The lowest functional status category was associated with a 4-fold increased odds of 720-day post-discharge mortality.
- This association was more pronounced in older adults (≥65 years).
- Functional status improvement before discharge was linked to a 52% decrease in mortality odds.
Conclusions:
- Functional status at hospital discharge is a significant predictor of long-term mortality in trauma intensive care unit survivors.
- Early assessment and improvement of functional status are critical for enhancing long-term survival.
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