Article

OBJECTIVES: To describe the trajectory of physical and mental health from injury
to 5 years postinjury for patients with multiple trauma, and to examine
predictors of recovery of physical and mental health.
DESIGN: A prospective,
longitudinal cohort study with data from injury (baseline), the return home (t1),
and 1 (t2), 2 (t3), and 5 (t4) years. SETTING: Hospital and community setting.
PARTICIPANTS: Patients (N=105; mean age +/- SD, 35.3+/-14.0y; age range, 18-67y;
83% men) with multiple trauma and a New Injury Severity Score (NISS) >/=16
treated at a regional trauma referral center. Mean NISS +/- SD was 34.6+/-12.6,
and mean Glasgow Coma Scale (GCS) score +/- SD was 12.2+/-3.9. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: Medical Outcomes Study 36-Item Short-Form
Health Survey physical component summary (PCS) and mental component summary
(MCS), injury severity parameters, and World Health Organization Disability
Assessment Schedule II (WHODAS II) for activities and participation. RESULTS: The
proportion with poor physical health (<40 points on the PCS) stabilized at 56% at
t4 from 81% at t1. The proportion with poor mental health (<40 points on the MCS)
stabilized at 31% at t4 from 43% at t1. Generalized estimating equations showed
that predictors of PCS were time points of measurement
(Wald, 85.50; P<.001), GCS
(B=-.48, P=.004), time in hospital/rehabilitation (B=-.22, P=.001), and the
rank-transformed WHODAS II subscales Getting around (B=.16, P<.001) and
Participation in society (B=.06, P=.015). Predictors of MCS were time points of
measurement (Wald 13.46, P=.004), sex (men/women) (B=-4.24, P=.003), education
(low/high) (B=3.43, P=.019), and WHODAS II cognitive function (B=.18, P<.001) and
Participation in society (B=.18, P</=.001). CONCLUSIONS: Physical and mental
health over the 5 years improved with time, but was still significantly below
population means. The physical and mental health status stabilized, but the
recovery trajectories differed for physical and mental health. Predictors of
health were personal and injury-related factors and function in a biopsychosocial perspective.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS