Does Additional Head Trauma Affect the Long-term Outcome After Upper Extremity Trauma in Multiple Traumatized Patients: Is There an Additional Effect of Traumatic Brain Injury?

Abstract

Background Musculoskeletal injuries are common in patients with multiple trauma resulting in pain, functional deficits, and disability. Traumatic brain injuries (TBIs) are common in severely injured patients potentially resulting in neurological impairment and permanent disability that would add to that from the musculoskeletal injuries. However, it is unclear to what degree the combination affects impairment.

Long-term employment outcomes following traumatic brain injury and orthopaedic trauma: A ten-year prospective study

“…After controlling for TBI severity and personal factors, there was no evidence of orthopaedic injuries contributing to employment status over 10 years post-injury. This is in accordance with previous suggestions of reduced contribution of other injuries to long-term employment outcomes for individuals with TBI (4,9). Difficulties with physical functioning and motor deficits have, however, been associated with poorer employment outcomes 7 or more years following moderate to severe TBI (29,30) and general major trauma (11).…”

“…Other injuries frequently occur in conjunction with TBI. Whilst comorbid injuries, especially orthopaedic limb injuries, contribute to poorer outcomes over the first year following TBI (8), their influence seems to reduce over the longer term (4,9). There are similarities, however, between patterns of employment following TBI and polytrauma (10)(11)(12)(13)(14).…”

Acute Trauma Factor Associations With Suicidality Across the First 5 Years After Traumatic Brain Injury

“…Individuals sustaining polytraumatic injuries, including TBI, have poorer recovery over time than those with TBI alone or ECI alone. 50,51 Therefore, this is the first study specifically examining ECI severity after TBI as it relates to both SI and SA. Our results may have parallel implications for ECI in the military setting, a population at high risk for polytrauma.…”

Assessment of Patient-Reported Outcomes After Polytrauma: A Systematic Review

“…Six publications were related to the Hannover Rehab study (35,(41)(42)(43)(44)(45). Four reported the results of a polytrauma study project conducted at the University Hospital Basel, which included a subproject of a study project (EK 159/02) and a polytrauma cohort (46)(47)(48)(49).…”

“…In addition, four preference-based tools were applied: European Quality of Life 5-Dimension (EQ-5D, n = 9, 17%) (7, 46-49, 51, 53, 70, 75), EQ-6D (n = 1, 2%) (33), Health Utility Index Mark 2 (HUI 2, n = 1, 2%) (75), and HUI 3 (n = 1, 2%) (75). Three trauma-speci c instruments were used: Hannover Score for Polytrauma Outcome (HASPOC, n = 6, 11%) (35,(41)(42)(43)(44)(45), Trauma Outcome Pro le (TOP, (n = 4, 7%) (46,48,49,70), and Aachen Long-term Outcome Score (ALOS, n = 1, 2%) (46). The Polytrauma Outcome Chart (POLO Chart, n = 6, 11%) (38-40, 56, 76, 77) was used as a modular instrument consisting of the Glasgow Outcome Pro le, SF-36, EQ-5D, and TOP.…”