Disability after severe injury: five year follow up of a large cohort

The early outcome for severely injured patients has improved in the last 20 years, but the level of continuing long term disability in such patients is not known. A large cohort of severely injured patients (ISS > 15) were interviewed and examined approximately 5 years following their injury. We present the preliminary results which show that only 30 per cent had made a full recovery, and that an alarming 47 per cent remain with moderate, severe or very severe disabilities. A large proportion (45%) of the persisting disability is due to pelvic and limb injury (74 per cent if brain and spinal cord injuries are excluded). This study reflects initial treatment in 13 District General Hospitals and one Teaching Hospital in a single geographical region in 1989 and 1990, and is the first such study in the UK. We conjecture whether more aggressive and specialized treatment and rehabilitation, especially of orthopaedic injuries, would improve these disappointing results.