Rehabilitation outcomes based on service provision and geographical location for patients with multiple trauma: A mixed-method systematic review

Jones, Suzannah M.; West, C.; Rappoport, Jacqueline; Akhtar, Kash

doi:10.1016/j.injury.2023.01.034

Cited by 3 publications

(4 citation statements)

References 51 publications

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“…The most important predictor of unmet needs at 12 mos was global function on GOSE at 6 mos. More severe disability increased the probability of having unmet needs, which is in line with previous studies on traumatic brain injury 8,23 . Although in a previous study, initial injury aspects may have a negative effect on outcome during the first years after moderate-to-severe trauma, 2 the results at the 12-mo follow-up suggest that this effect seems to decrease over time.…”

Section: Discussionsupporting

confidence: 88%

“…Based on the functional levels on GOSE, nonsubstantial functional changes from 6 to 12 mos were captured; however, service needs might have changed from ongoing and persistent to intermittent, from professional support to self-management strategies. Others have shown that physiotherapy is a frequently provided rehabilitation service 23 ; however, over time, there might be needs, and hence also unmet needs, for vocational rehabilitation services, mental health services, or social support measures 9 that arise, which would facilitate improved global function.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Needs for community-based rehabilitation services and support 12 months after moderate and severe physical traumatic injuries: a brief report

Andelic,

Moksnes,

Rasmussen

et al. 2024

Am J Phys Med Rehabil

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Patients with physical traumatic injuries frequently require long-term rehabilitation services. To strengthen rehabilitation services in the post-acute phase, we need to assess characteristics of this population and their healthcare and rehabilitation needs in the community. This brief report summarizes the frequency of unmet rehabilitation needs in community-based rehabilitation during the first year after moderate and severe trauma. Additionally, the associations between sociodemographic, injury severity factors and unmet needs were examined. Data from a prospective multicenter cohort study of patients with moderate and severe trauma (New Injury Severity Score > 9) of all ages discharged alive from two regional trauma centers in 2020 were used. Needs were estimated using the Needs and Provision Complexity Scale. Overall, 46% of patients had unmet needs at 12 months post-injury, particularly related to the provision of rehabilitation services, specialist follow-ups, and social and family support. The probability of unmet needs was associated with age, pre-injury comorbidities, and impaired functioning. Our findings support strategies targeting younger patients, those with pre-injury comorbidities, and those with higher levels of disability and provide a starting point for the development of standardized rehabilitation needs assessment and guidelines following injury.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Needs for community-based rehabilitation services and support 12 months after moderate and severe physical traumatic injuries: a brief report

Andelic,

Moksnes,

Rasmussen

et al. 2024

Am J Phys Med Rehabil

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“…Our findings, however, support the need to establish a strategy to specifically target patients with a higher level of pre-injury comorbidity, a higher number of injuries, and higher estimated rehabilitation needs. It is important to note that there is, currently, limited knowledge regarding rehabilitation needs following trauma [ 40 , 41 ]. A recent systematic review on service provision revealed variations in the rehabilitation and complexities experienced by patients after trauma events [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is important to note that there is, currently, limited knowledge regarding rehabilitation needs following trauma [ 40 , 41 ]. A recent systematic review on service provision revealed variations in the rehabilitation and complexities experienced by patients after trauma events [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

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

Moksnes

Schäfer

Rasmussen

et al. 2023

JCM

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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.

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The three stages of polytrauma rehabilitation– a recommendation and a systematic literature review on behalf of SICOT

Klingebiel,

Landre,

Hasegawa

et al. 2024

International Orthopaedics (SICOT)

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Purpose Polytrauma presents a devastating event with great impact on the patient’s life. While we are taking great care of improving our treatment algorithms, the rehabilitation often takes place outside of our direct field of vision. Yet, adequate rehabilitation is crucial for the patients to regain their former lives. The aim of this study, on the behalf of SICOT Trauma & Rehabilitation Research Group, was to identify rehabilitation strategies and standards in existing scientific literature. Methods A systematic literature search of MEDLINE and Embase from 2000 to 2023 was conducted. Inclusion criteria was the description of polytrauma rehabilitation strategies in the acute, post-acute or long-term stage. Reported treatment aims, conducted therapies and challenges were extracted and stratified to either of the stages. Results A total of 5212 studies were identified and 6 reviews and one original study were included according to our criteria. Overall, no article of higher evidence on how to perform polytrauma rehabilitation could be identified. From the available literature, disciplines involved in the rehabilitation could be described such as major challenges along the rehabilitation process. Conclusion This study highlights the need for standardized polytrauma rehabilitation algorithms. Whereas we could identify important information about each rehabilitation stage, we did not encounter specific evidence for prioritization of different therapies or algorithms of treatment. Polytrauma rehabilitation needs to shift from eminence to evidence.

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Rehabilitation outcomes based on service provision and geographical location for patients with multiple trauma: A mixed-method systematic review

Cited by 3 publications

References 51 publications

Needs for community-based rehabilitation services and support 12 months after moderate and severe physical traumatic injuries: a brief report

Needs for community-based rehabilitation services and support 12 months after moderate and severe physical traumatic injuries: a brief report

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

The three stages of polytrauma rehabilitation– a recommendation and a systematic literature review on behalf of SICOT

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