Functional Outcomes at 6 and 12 Months Post-Injury in a Trauma Centre Population with Moderate-to-Severe Traumatic Injuries

Håkon Øgreid Moksnes; Christoph Schäfer; Mari Storli Rasmussen; Helene Lundgaard Soberg; Olav Røise; Audny Anke; Cecilie Røe; Pål Aksel Næss; Christine Gaarder; Eirik Helseth; Hilde Margrete Dahl; Morten Hestnes; Cathrine Brunborg; Nada Andelic; Torgeir Hellstrøm

doi:10.3390/jcm12165300

Functional Outcomes at 6 and 12 Months Post-Injury in a Trauma Centre Population with Moderate-to-Severe Traumatic Injuries

J Clin Med. 2023 Aug 15;12(16):5300. doi: 10.3390/jcm12165300.

Authors

Håkon Øgreid Moksnes^{1

2}, Christoph Schäfer^{1

2

3

4}, Mari Storli Rasmussen^{1

2

5}, Helene Lundgaard Soberg^{1

5}, Olav Røise^{6

7}, Audny Anke^{2

3

4}, Cecilie Røe^{1

2

7}, Pål Aksel Næss^{7

8}, Christine Gaarder^{7

8}, Eirik Helseth^{7

9}, Hilde Margrete Dahl^{7

10}, Morten Hestnes^{11

12}, Cathrine Brunborg¹³, Nada Andelic^{1

2}, Torgeir Hellstrøm¹

Affiliations

¹ Department of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
² Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, P.O. Box 1072 Blindern, N-0316 Oslo, Norway.
³ Department of Clinical Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, P.O. Box 6050 Langnes, N-9037 Tromsø, Norway.
⁴ Department of Rehabilitation, University Hospital of North Norway, P.O. Box 100, N-9038 Tromsø, Norway.
⁵ Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs Plass, N-0130 Oslo, Norway.
⁶ Norwegian Trauma Registry, Division of Orthopaedic Surgery, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
⁷ Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, P.O. Box 1072 Blindern, N-0316 Oslo, Norway.
⁸ Department of Traumatology, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
⁹ Department of Neurosurgery, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
¹⁰ Department of Child Neurology, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
¹¹ Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
¹² Oslo University Hospital Trauma Registry, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.
¹³ Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, P.O. Box 4956 Nydalen, N-0424 Oslo, Norway.

Abstract

This study aims to evaluate the global functional outcomes after moderate-to-severe traumatic injury at 6 and 12 months and to examine the sociodemographic and injury-related factors that predict these outcomes. A prospective cohort study was conducted in which trauma patients of all ages with a New Injury Severity Score > 9 who were discharged alive from two regional trauma centres in Norway over a one-year period (2020) were included. The Glasgow Outcome Scale Extended (GOSE) score was used to analyse the functional outcomes. Regression analyses were performed to investigate the predictors of the GOSE score. Follow-up assessments were obtained from approximately 85% of the 601 included patients at both time points. The mean (SD) GOSE score was 6.1 (1.6) at 6 months and 6.4 (1.6) at 12 months, which corresponds to an upper-moderate disability. One-half of the patients had a persistent disability at 12 months post-injury. The statistically significant predictors of a low GOSE score at both time points were more pre-injury comorbidity, a higher number of injuries, and higher estimated rehabilitation needs, whereas a thorax injury with an Abbreviated Injury Scale ≥ 3 predicted higher GOSE scores. A high Glasgow Coma Scale score at admission predicted a higher GOSE score at 6 months. This study strengthens the evidence base for the functional outcomes and predictors in this population.

Keywords: GOSE; functional outcome; multiple trauma; prediction; rehabilitation; rehabilitation needs; traumatic injury.

Grants and funding

2019043/Southern and Eastern Norway Regional Health Authority