Disability in young adults following major trauma: 5 year follow up of survivors

Abstract

Background: Injuries are a major cause of mortality and morbidity in young people. Despite this, the long-term consequences for young survivors of severe injury are relatively unexplored.

Methods: Population based cohort study involving 5 year post injury structured interview of all cases of major trauma (Injury Severity Score > 15) identified retrospectively for 12 month period (1988 to 1989) within former Yorkshire Health Authority area of the United Kingdom.

Results: 125 individuals aged 11-24 years at time of injury were identified. Of these, 109 (87%) were interviewed. Only 20% (95% CI 14-29%) of those interviewed reported no disability. Mean Office of Population Census and Surveys (OPCS) disability score of the remainder was 7.5 (median 5.8, range 0.5 to 19.4). The most commonly encountered areas of disability were behaviour (54%, 95% CI 45-63%), intellectual functioning (39%, 95% CI 31-49%) and locomotion (29%, 95% CI 22-39%). Many respondents reported that their daily lives were adversely affected by their health problems for example, causing problems with work, 54% (95% CI 45-63%), or looking after the home, 28% (95% CI 21-38%). Higher OPCS scores were usually but not always associated with greater impact on daily activities. The burden of caring responsibilities fell largely on informal carers. 51% (95% CI 42-61%) of those interviewed would have liked additional help to cope with their injury and disability.

Conclusion: The study has revealed significant disability amongst a cohort of young people 5 years post severe injury. Whilst many of these young people were coping well with the consequences of their injuries, others reported continuing problems with the activities of daily life. The factors underpinning the young people's differing experiences and social outcome should be explored.

Figure 1

OPCS scores for subjects at follow up (total group n = 109)