Association Between 6-Week Postdischarge Risk Classification and 12-Month Outcomes After Orthopedic Trauma

Area of Science:

• Orthopedic Surgery
• Psychosocial Health
• Trauma Recovery

Background:

• Long-term outcomes in orthopedic trauma are linked to early psychosocial and behavioral health.
• Identifying actionable subgroups within this patient population remains challenging.

Purpose of the Study:

• To determine if risk and protective factors at 6 weeks post-injury can classify patients into risk clusters.
• To evaluate if these clusters predict 12-month recovery outcomes.

Main Methods:

• Prospective observational study of 352 severe orthopedic trauma patients.
• Assessed risk (pain, depression, PTSD, alcohol, tobacco) and protective (resilience, social support, self-efficacy) factors at 6 weeks.
• Latent class analysis used to identify patient clusters and evaluate 12-month outcomes (function, depression, PTSD, self-rated health).

Main Results:

• Latent class analysis identified 6 distinct patient clusters, clinically collapsible into 4 groups from best to worst outcomes.
• Significant differences in 12-month functional outcomes were observed across the 4 clinical groupings.
• The worst group showed substantially poorer Short Musculoskeletal Function Assessment scores compared to the best group.

Conclusions:

• Patients with orthopedic trauma can be classified into risk/protective clusters early in recovery.
• These clusters significantly explain variance in 12-month functional and health outcomes.
• Early classification supports personalized postsurgical care, potentially conserving resources and optimizing patient management.