Relationship between health status and functional outcome during two years after a severe trauma

• Published in: Injury Vol. 51; no. 12; pp. 2953 - 2961
• Main Authors: Havermans, Roos J.M., Lansink, Koen W.W., de Munter, Leonie, de Jongh, Mariska A.C.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-12-2020
• Subjects: Functional outcome; Health status; Prognostic factors; Severe injury; Severe injury; Health status; Prognostic factors; Functional outcome
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2020.09.022

•Functional outcome and health status improved over time but two years after a severe trauma the percentage of problems remains higher compared to their pre-injury reported problems.•There is a good relationship between functional outcome and health status during two years after a severe trauma.•Functional outcome could be used to determine patients at risk for both a lower functional outcome and a lower health status after a severe injury.
With the improved survival rates after trauma, the population of patients with disabilities increased. The knowledge about functional outcome and the relationship between health status and functional outcome is limited. The aim of the present prospective cohort study was to describe the functional outcome and health status over time, and the relationship between both.
Adult severely injured patients (ISS≥16) were included if hospitalised in Noord-Brabant within 48 h after injury between August 2015 and December 2016. The functional outcome (Glasgow Outcome Scale Extended - GOSE) and health status (EQ-5D) were measured at 1, 3, 6, 12 and 24 months after injury. Logistic and linear mixed models were used to examine functional outcome and health status over time. Measurements were divided into short- (1–3 months), mid- (6–12 months) and long-term (24 months).
In total 239 severely injured patients were included. Functional outcome and health status improved over time. Prognostic factors during two years were a longer hospital length of stay, female gender and Glasgow Coma Scale. Besides age was a prognostic factor for health status and education level for functional outcome. A higher ASA classification was a long-term prognostic factor for a lower functional outcome and a lower health status. The patients with a good functional recovery showed a significant higher EQ-5D utility score and patients with a poor functional recovery reported significant more problems in the EQ-5 domains.
There is a good relationship between the functional outcome and the health status during two years after a severe injury. It appears reliable to use functional outcome in terms of physical impairments in daily clinic to determine patients at risk for both a lower functional outcome and a lower health status over time.