Physical functionality two years after major trauma: predictors from a single center cohort study.

Area of Science:

• Trauma surgery
• Rehabilitation medicine
• Public health

Background:

• Traumatic injuries pose a significant global health challenge, leading to long-term disability and reduced quality of life.
• Impaired physical function post-trauma impacts patients' emotional well-being and social engagement.
• Identifying predictors of functional recovery is crucial for effective patient management.

Purpose of the Study:

• To examine patient-reported physical functionality before and after major trauma.
• To identify key predictors associated with poor functional recovery post-trauma.
• To understand the long-term physical outcomes in major trauma survivors.

Main Methods:

• Retrospective single-center cohort study of 515 major trauma patients (Injury Severity Score ≥ 9, ICU admission, age ≥ 18).
• Assessment of physical functionality at 23 months post-trauma using standardized questionnaires (Trauma Outcome Profile, Abbreviated Injury Scale).
• Analysis of clinical data including Injury Severity Score and patient demographics.

Main Results:

• Physical functionality significantly declined 23 months post-trauma (94.8 to 72.9), with nearly half below a critical threshold.
• Pre-trauma physical functionality was the strongest predictor of post-trauma impairment (OR 8.21).
• Older age (50-59 vs 18-29) and lower extremity/pelvic injuries were also significant predictors (OR 2.75 and OR 1.60, respectively).

Conclusions:

• Pre-trauma physical function and patient age are primary determinants of long-term functional outcomes after major trauma.
• Lower extremity injuries are associated with poorer functional recovery, independent of overall injury severity.
• Overall injury severity (ISS) was not an independent predictor of long-term functional impairment.