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One-year functional outcomes following major trauma: experience of a UK level 1 major trauma centre
Wail Ahmed1, Rupali Alwe2, Derick Wade3
11 National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, UK.
Insights
A postal questionnaire achieved a 43% complete data response rate for major trauma patient outcomes one year after injury. Functional outcomes, such as mobility and self-care, showed significant challenges for survivors.
Area of Science:
- Trauma Surgery and Critical Care
- Rehabilitation Medicine
- Health Services Research
Background:
- Routine outcome data collection is crucial for evaluating trauma care effectiveness.
- Long-term functional outcomes after major trauma significantly impact patient quality of life.
- Standardized data collection methods are needed to assess post-trauma recovery.
Purpose of the Study:
- To pilot a postal questionnaire for routine outcome data collection one year post-admission.
- To determine current outcomes for major trauma patients.
- To identify methodological improvements for future data collection.
Main Methods:
- A postal questionnaire audit was conducted.
- 355 patients, 12 months post-admission with major trauma (Injury Severity Score ≥ 9), were surveyed.
- Data collected included Injury Severity Score (ISS), EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), functional status, employment, and accommodation.
Main Results:
- A 43% complete data response rate was achieved from 355 mailed questionnaires.
- Among respondents, 91 patients reported new mobility problems and 54 had new personal care difficulties.
- No association was found between Injury Severity Score and patient-reported outcome scores.
Conclusions:
- A single, simple postal questionnaire can achieve a 43% complete data response rate.
- Outcome data align with existing literature on major trauma recovery.
- Focusing on specific functional outcomes may yield the most sensitive data for assessing recovery.
Objective:
To pilot a method for routine outcome data collection one year after admission to a major trauma centre, to determine current outcomes, and to identify possible methodological improvements.
Design:
A postal questionnaire audit.
Setting:
A major trauma centre in the United Kingdom.
Subjects:
In total, 355 patients known to be alive 12 months after admission with major trauma (Injury Severity Score (ISS) of 9 or more).
Interventions:
All patients received standard trauma and rehabilitation services available to them.
Main Measures:
The main measures used are as follows: ISS; EuroQol, five dimensions five levels (EQ-5D-5L); single questions about accommodation, mobility, and self-care; demographic and injury data collected from hospital records; and outcome data by postal questionnaire.
Results:
In total, 429 patients were registered over six months: at one year, 64 had died and 10 had no UK address. In total, 355 questionnaires were sent out: 179 (50%) were never returned, 154 (43%) were returned with complete data, 11 forms were incomplete, 7 patients were dead, and 4 were not at the address contacted. Of the 154 with complete data, 91 had new mobility problems and 54 had new problems with personal activities. Of the 68 previously employed, 19 were unemployed, 38 were fully employed in the same job, and 13 had altered jobs. There was no association between Injury Severity Score and any of the outcome scores.
Conclusion:
A short simple questionnaire sent only once achieved a complete data set response rate of 43%. The outcome data are consistent with experience in other studies. Collection of data on specific functional outcomes might be most sensitive.
