Elsevier

Australian Critical Care

Volume 18, Issue 1, February 2005, Pages 17-24
Australian Critical Care

Life beyond severe traumatic injury: an integrative review of the literature

https://doi.org/10.1016/S1036-7314(05)80020-7Get rights and content

It is only recently that recognition of the serious and debilitating sequelae of trauma has prompted exploration of outcomes beyond survival, such as disability, health status and quality of life. This paper aims to review the literature describing outcomes following severe traumatic injury to provide clinicians with a greater understanding of the recovery trajectory following severe trauma and highlight the issues faced by those recovering from such injury. Electronic databases, published reference lists and the Internet were searched to identify relevant literature. The heterogeneous nature of published literature in this area prohibited a systematic approach to inclusion of papers in this review.

Trauma survivors report significant sequelae that influence functional status, psychological wellbeing, quality of life and return to productivity following severe injury. Key themes that emerge from the review include: current trauma systems which provide inadequate support along the recovery trajectory; rehabilitation referral which is affected by geographical location and provider preferences; a long-term loss of productivity in both society and the workplace; a high incidence of psychological sequelae; a link between poor recovery and increased drug and alcohol consumption; and valued social support which can augment recovery.

Future research to evaluate interventions which target the recovery needs of the severely injured patients is recommended. Particular emphasis is required to develop systematic, sustainable and cost-effective follow-up to augment the successes of existing acute trauma services in providing high quality acute resuscitation and definitive trauma management.

References (92)

  • MaltU et al.

    The three-year biophysical outcome of 551 hospitalized accidentally injured adults

    Acta Psychiatrica Scandinavica

    (1989)
  • StalpM et al.

    Standardised outcome evaluation after blunt multiple injuries by scoring systems: a clinical follow-up investigation 2 years after injury

    The Journal of Trauma

    (2002)
  • StrohmyerLL et al.

    Adaption six months after multiple trauma: a pilot study

    The Journal of Neuroscience Nursing

    (1993)
  • YatesDW et al.

    Preliminary analysis of the care of injured patients in 33 British hospitals: first report of the United Kingdom major trauma outcome study

    British Medical Journal

    (1992)
  • HeylandDK et al.

    Frequency and methodologic rigor of quality-of-life assessments in the critical care literature

    Critical Care Medicine

    (1998)
  • HolbrookTL et al.

    Outcome after major trauma: discharge and 6-month follow-up results from the trauma recovery project

    The Journal of Trauma

    (1998)
  • HolbrookTL et al.

    The impact of major inhospital complications on functional outcome and quality of life after trauma

    The Journal of Trauma

    (2001)
  • LongAF et al.

    The role of the nurse within the multi-professional rehabilitation team

    Journal of Advanced Nursing

    (2002)
  • MichaelsAJ et al.

    Outcome from injury: general health, work status and satisfaction 12 months after trauma

    The Journal of Trauma

    (2000)
  • O'KeefeGE et al.

    Defining excess resource utilisation and identifying associated factors for trauma victims

    The Journal of Trauma

    (1999)
  • FernKT et al.

    Trauma patients with multiple extremity injuries: resource utilisation and long-term outcome in relation to injury severity scores

    The Journal of Trauma

    (1998)
  • MorrisS et al.

    Outcome after musculoskeletal trauma treated in a regional hospital

    The Journal of Trauma

    (2000)
  • OsbergJS et al.

    Utilization of inpatient rehabilitation service among traumatically injured children discharged from pediatric trauma centers

    American Journal of Physical Medicine & Rehabilitation

    (1990)
  • CraigMC et al.

    Psychosocial considerations in trauma care

    Critical Care Nursing Quarterly

    (1988)
  • JurkovichGJ et al.

    The sickness impact profile as a tool to evaluate functional outcome in trauma patients

    The Journal of Trauma

    (1995)
  • MacKenzieEJ et al.

    Factors influencing return to work following hospitalisation for traumatic injury

    American Journal of Public Health

    (1987)
  • MullinsRJ et al.

    Adequacy of hospital discharge status as a measure of outcome among injured patients

    JAMA

    (1998)
  • SalekS

    Compendium of Quality of Life Instruments

    (1998)
  • SugrueM et al.

    Trauma outcomes: a death analysis study

    Irish Journal of Medical Science

    (1996)
  • BrooksRG et al.

    Quality of life outcomes after intensive care: comparison with a community group

    Intensive Care Medicine

    (1997)
  • DePalmaJA

    Measuring quality of life of patients with traumatic brain injury

    Critical Care Nursing Quarterly

    (2001)
  • GuyattGH et al.

    Measuring health-related quality of life

    Annals of Internal Medicine

    (1993)
  • HallJ

    The challenge of health outcomes

    Journal of Quality in Clinical Practice

    (1996)
  • HobartJC et al.

    Evidence-based measurement: which disability scale for neurologic rehabilitation?

    Neurology

    (2001)
  • HolbrookTL et al.

    Functional limitation after major trauma: a more sensitive assessment using the Quality of Well-Being scale. The Trauma Recovery Pilot Project

    The Journal of Trauma

    (1994)
  • van der SluisCK et al.

    Multiple injuries: an overview of the outcome

    The Journal of Trauma

    (1995)
  • World Health Organisation

    International Classification of Functioning, Disability and Health

    (2001)
  • CorbinJM et al.

    A nursing model for chronic illness management based upon the trajectory framework

    Scholarly Inquiry for Nursing Practice

    (1991)
  • RichmondTS

    An explanatory model of variables influencing post injury disability

    Nursing Research

    (1997)
  • SmeltzerSC

    Research in trauma nursing: state of the art and future directions

    Journal of Emergency Nursing

    (1988)
  • MacKenzieEJ et al.

    Functional recovery and medical costs of trauma: an analysis by type and severity of injury

    The Journal of Trauma

    (1988)
  • AnkeAGW et al.

    Long-term prevalence of impairments and disabilities after multiple trauma

    The Journal of Trauma

    (1997)
  • DaceyR et al.

    Relative effects of brain and non-brain injuries on neuropsychological and psychological outcome

    The Journal of Trauma

    (1991)
  • GlancyKE et al.

    A study of recovery in trauma patients

    The Journal of Trauma

    (1992)
  • MockC et al.

    Determinants of disability after lower extremity fracture

    The Journal of Trauma

    (2000)
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