Voorspellende factoren van functionele beperkingen na ernstig letsel

OBJECTIVE: To assess the health-related quality of life and prognostic factors of disability in survivors of severe trauma one year after injury. DESIGN:Prospective cohort study. METHOD: All severely-injured trauma patients presenting at a level I trauma centre during a 30-month period and surviving 30 days after admission were included. The EuroQol-5D (EQ-5D) and Health Utilities Index (HUI) were used to determine the health status 12 months after injury. RESULTS: 362 patients were included during the study period, 246 of whom returned the follow-up assessments (response rate: 68%). The median EQ-5D utility score was 0.73 (EQ-5D Dutch general population norm: 0.88). The HUI2, HUI3 and EQ-5D Visual Analogue Scale scores were 0.81, 0.65 and 70, respectively. One year after trauma only 22% of the patients reported no functional limitation in the 5 domains of the EQ-D5. Females and patients with co-morbidity at the time of the injury had a higher risk of low scores after 1 year. CONCLUSION: One year after severe injury, the functional outcome and quality of life of trauma patients were far from normalized. Female gender and comorbidity were predictors of poorer functional outcome.