Citation

Copes WS, Stark MM, Lawnick MM, Tepper S, Wilkerson D, DeJong G, Brannon R, Hamilton BB. J. Trauma 1996; 40(3): 428-436.

Affiliation

Tri-Analytics, Inc., Bel Air, Maryland, USA.

Copyright

(Copyright © 1996, Lippincott Williams and Wilkins)

DOI

unavailable

PMID

8601862

Abstract

OBJECTIVE: To evaluate te feasibility of retrospectively creating a data base useful in trauma systems evaluations. MATERIALS AND METHODS: Records for 375 patients in both the Major Trauma Outcome Study and the Uniform Data System for Medical Rehabilitation were linked to create an injury-through-rehabilitation data base, including patients from four impairment groups: traumatic brain injury (TBI); spinal cord injury --paraplegic complete (SCI-PARA) and quadriplegic complete (SCI-QUAD); and hip fracture (HIP-FX). MEASUREMENTS AND MAIN RESULTS: The average ages (25.1 years SCI-QUAD, 72.6 years HIP-FX); Injury Severity Score (10.2 HIP-FX, 31.7 SCI-PARA); Revised Trauma Score (5.9 TBI, 7.8 HIP-FX); and acute care lengths of stay (13.3 days HIP-FX, 24.2 days TBI) varied substantially over the four groups. On average, patients spent from approximately 20 days (HIP-FX) to nearly 100 days (SCI-QUAD) in rehabilitation. Functional gains during rehabilitation were primarily in motor skills, but TBI patients also made substantial cognitive gains. Nearly 90% of TBI and SCI patients were discharged to their homes; the percentage of HIP-FX patients discharged to their homes, however, was lower (74%). Across all impairment groups, more patients lived with their relatives after rather than before injury. The correlation between a summary Major Trauma Outcome Study-Functional Independence Measure assessed at acute care discharge and the complete Uniform Data System for Medical Rehabilitation-Functional Independence Measure assessed on admission to rehabilitation was significant for all study patients and for each impairment group except SCI_PARA. CONCLUSIONS: Linking records to create the study data base was arduous and could not be practically accomplished on a large scale or on a continuing basis. Because of the growing emphases on trauma system evaluations and outcomes beyond survival at acute care discharge, we recommend the routine inclusion of rehabilitation data in hospital-based trauma registries.