Evaluating time points for measuring recovery after major trauma in adults

Ann Surg. 2013 Jan;257(1):166-72. doi: 10.1097/SLA.0b013e31825d7422.


Objective: To evaluate recovery after major trauma over a 24-month time frame.

Background: Measuring disability after injury is seen as increasingly important but requires knowledge not only of the measures that should be implemented but also of the critical time points for follow-up.

Methods: Six hundred sixty-two adult major trauma patients from 2 level 1 trauma centers (October 2006 to March 2007) were followed up by telephone at 6-, 12-, 18-, and 24 months after injury. SF-12, Glasgow Outcome Scale-Extended (GOS-E), pain scores, and return to work (RTW) were collected. Multilevel mixed-effects regression models were fitted to analyze change in outcomes over time.

Results: Six hundred seventeen (93%) were followed up for at least 1 time point. Functional recovery (GOS-E = 8) [odds ratio (OR) 3.1, 95% CI: 1.9, 5.0] and RTW (OR 2.4, 95% CI: 1.4, 4.0) improved, and physical health (PCS-12) scores were better (mean difference 1.9, 95% CI: 0.9, 2.9), from 6 to 12 months after injury, but changed little from 12 months. Pain scores were unchanged from 6 to 12 months but were higher at 18 months than at 12 months (OR 1.8, 95% CI: 1.2, 2.8). SF-12 mental health (MCS-12) scores decreased until 18 months but improved from 18 to 24 months (mean difference 1.5, 95% CI: 0.2, 2.8). The rate of recovery differed by injury group and age.

Conclusions: Different patterns of recovery were evident for each outcome, and there was a variation in the rate of recovery for some subgroups. The selection of time points for follow-up requires consideration of the outcome measurements of interest and the population being studied.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Disability Evaluation*
  • Female
  • Follow-Up Studies
  • Glasgow Outcome Scale
  • Health Status
  • Health Status Indicators
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Quality of Life
  • Recovery of Function
  • Registries
  • Regression Analysis
  • Return to Work
  • Time Factors
  • Victoria
  • Wounds and Injuries / rehabilitation*
  • Young Adult