One-year functional outcomes following major trauma: experience of a UK level 1 major trauma centre

Abstract

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.

Keywords: Trauma; disability outcome; service improvement.