The impact of in-hospital complications on the long-term functional outcome of trauma patients: A multicenter study.
Journal
Surgery
ISSN: 1532-7361
Titre abrégé: Surgery
Pays: United States
ID NLM: 0417347
Informations de publication
Date de publication:
09 2019
09 2019
Historique:
received:
23
01
2019
revised:
11
04
2019
accepted:
24
04
2019
pubmed:
3
7
2019
medline:
21
1
2020
entrez:
3
7
2019
Statut:
ppublish
Résumé
The long-term consequences of in-hospital complications remain largely unknown. We sought to study the effect of complications on the long-term functional outcome of trauma patients. Patients with an Injury Severity Score ≥ 9 admitted to 3, level I trauma centers between 2015 and 2017 were contacted 6 to 12 months postinjury and administered a validated trauma quality-of-life survey, assessing for the presence of any functional limitation. Functional limitation was defined as the inability to perform independently one or more activities of daily living (eg, driving, walking on flat surfaces/upstairs, dressing). Medical records and the trauma registry were reviewed systematically for all patient and injury variables. The occurrence of predefined in-hospital complications (eg, pneumonia, surgical site infection) was recorded. The impact of in-hospital complications on functional limitation was assessed using multivariate logistic regression models. Of 1,709 patients, 1,022 completed the study. The mean age was 58 y, 56% were male, 94% had blunt trauma, and the mean Injury Severity Score was 15. A total of 168 patients (16.4%) had a minimum of 1 in-hospital complication and reported significantly more functional limitations in most activities of daily living at 6 to 12 months, compared with those without complications. In multivariable analyses adjusting for confounders, the occurrence of complications was associated with a greater likelihood of functional limitation 6 to 12 months postinjury (odds ratio = 1.82, 95% confidence interval 1.22-2.69, P = .003). Trauma patients with in-hospital complications have a worse long-term functional outcome. In addition to prevention of primary complications, more rehabilitation resources should be made available to trauma patients who survive complications.
Sections du résumé
BACKGROUND
The long-term consequences of in-hospital complications remain largely unknown. We sought to study the effect of complications on the long-term functional outcome of trauma patients.
METHODS
Patients with an Injury Severity Score ≥ 9 admitted to 3, level I trauma centers between 2015 and 2017 were contacted 6 to 12 months postinjury and administered a validated trauma quality-of-life survey, assessing for the presence of any functional limitation. Functional limitation was defined as the inability to perform independently one or more activities of daily living (eg, driving, walking on flat surfaces/upstairs, dressing). Medical records and the trauma registry were reviewed systematically for all patient and injury variables. The occurrence of predefined in-hospital complications (eg, pneumonia, surgical site infection) was recorded. The impact of in-hospital complications on functional limitation was assessed using multivariate logistic regression models.
RESULTS
Of 1,709 patients, 1,022 completed the study. The mean age was 58 y, 56% were male, 94% had blunt trauma, and the mean Injury Severity Score was 15. A total of 168 patients (16.4%) had a minimum of 1 in-hospital complication and reported significantly more functional limitations in most activities of daily living at 6 to 12 months, compared with those without complications. In multivariable analyses adjusting for confounders, the occurrence of complications was associated with a greater likelihood of functional limitation 6 to 12 months postinjury (odds ratio = 1.82, 95% confidence interval 1.22-2.69, P = .003).
CONCLUSION
Trauma patients with in-hospital complications have a worse long-term functional outcome. In addition to prevention of primary complications, more rehabilitation resources should be made available to trauma patients who survive complications.
Identifiants
pubmed: 31262570
pii: S0039-6060(19)30208-9
doi: 10.1016/j.surg.2019.04.026
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
398-402Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.