Functional outcome in patients with moderate and severe trauma in Hong Kong: 4 year prospective multicentre cohort study
Refereed conference paper presented and published in conference proceedings

Trauma care systems aim to reduce death and to improve quality of life and functional outcome in trauma patients. It is well documented that trauma systems result in improved survival after injury, yet there is little data on post-trauma functional outcome. Such evaluation of functional recovery is important as this will allow comparison with other settings, will help evaluate the impact and effectiveness of trauma systems as a whole, and may provide prognostic information for healthcare workers and patients. The aim of this study was to evaluate baseline, discharge, six month and 1, 2, 3 and 4 year post-trauma functional outcome and predictors of optimal functional outcome in Hong Kong.

Participants and methods
From 1st January to 30th September 2010 patients were recruited to a prospective multi-centre cohort study of trauma patients and then followed up for four years to 30th September 2015. The study was conducted in three trauma centres in Hong Kong. Adult patients aged ≥18 years with ISS≥9, entered into the trauma registry, and who survived the first 48 hours of injury were included. The main outcome measures included theextended Glasgow Outcome Scale (GOSE) and SF36.

During the study, 400 patients (mean age 53.3 years; range 18-106; 69.5% male) were recruited. There were no statistically significant differences in baseline characteristics between responders (N=143) and surviving non-responders (N=179). Only 81/400 (20.3%) cases reported a GOSE≥7. If non-responders had similar outcomes to responders, then the percentages for GOSE≥7 would rise from 20.3% to 45.6%. Univariate analysis showed that poor functional outcome at 48 months was significantly associated with admission to ICU (OR 2.267), ISS 26-40 (OR 3.231), baseline PCS on SF36 testing (OR 0.940), one-month PCS (OR 0.933), 6-month PCS (OR 0.904) and 6-month MCS on SF36 testing (OR 0.96).

At 48 months after injury, 45% of patients sustaining moderate or major trauma in Hong Kong had an excellent recovery. Admission to ICU, ISS 26-40, baseline PCS, one-month PCS, 6-month PCS and 6-month MCS predict 4-year functional outcome.

This study was supported by Health and Health Services Research Grant 07080261 and Health and Medical Research Fund Grant 10110251.
著者Colin A GRAHAM, Kevin Kc HUNG, Janice Hh YEUNG, Wai S POON, Hiu F HO, Chak W KAM, Timothy H RAINER
會議名稱10th European Congress on Emergency Medicine 2016
會議論文集題名10th European Congress on Emergency Medicine 2016

上次更新時間 2018-22-01 於 05:59