Acute and long-term outcomes of extremely injured blunt trauma victims

J Trauma. 1995 Aug;39(2):320-4. doi: 10.1097/00005373-199508000-00021.


Long-term outcomes after blunt trauma remain poorly defined. The purpose of this study was to document such outcomes in extremely injured adults (Injury Severity Score > or = 50). From April 1990 to June 1993, 76 patients (5% of all trauma victims) had an ISS > or = 50 at a single trauma center. Thirty-five (46%) survived to hospital discharge. The mean duration of hospital stay was longer for survivors than for nonsurvivors (92 days versus 16 days, p < 0.001). Of the 35 survivors, 26% were discharged directly home, 60% to a rehabilitation hospital, 8% to a chronic care facility, and 6% to an acute care hospital. After a mean follow-up of 27 months, 6% had died, 9% refused participation, and the remaining 30 patients (91% of long-term survivors) demonstrated significant residual disabilities in physical, emotional, and mental health status. We suggest that extremely injured patients comprise a small proportion of blunt trauma victims, consume substantial acute care hospital resources, often survive, and yet frequently have residual disability. A reduction in this long-term disability may represent the greatest challenge in modern trauma care.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Female
  • Health Status
  • Humans
  • Injury Severity Score
  • Length of Stay
  • Long-Term Care
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Quality of Life
  • Registries
  • Surveys and Questionnaires
  • Trauma Centers
  • Wounds, Nonpenetrating / mortality
  • Wounds, Nonpenetrating / physiopathology*
  • Wounds, Nonpenetrating / therapy