Introduction of a novel questionnaire to assess the quality of post-discharge outpatient care and socioeconomic state after severe multiple injury.

BACKGROUND: Trauma registries provide knowledge about the pathophysiological events that follow severe injuries but only little is known about outpatient care and socioeconomic consequences at later stages in case of survival. We introduce a novel questionnaire to specifically assess the quality of post-discharge outpatient care and socioeconomic burden up to two years after severe multiple injury.

DESIGN: Observational Study.

SETTING: Post-discharge outpatient treatment and socioeconomic burden within two years after severe trauma.

POPULATION: Severely injured adult trauma patients (Injury Severity Score 9 and ICU admission).

METHODS: A new questionnaire was introduced in context of a two-year follow-up mail survey.

RESULTS: The response rate was 57% (150/264 patients; 73% male, mean 45 years, mean ISS 17/New ISS 22; 99% blunt trauma). Rehabilitation measures were conducted in 70% of patients while 87% underwent outpatient treatment after discharge from the acute care facility. Further in-hospital stays were observed in 63% of patients and 19% reported the need for ongoing permanent care. Pain medication was taken by 74% of patients after discharge while 32% were still on pain medication at two years. 35% had been on sick leave >1 year while 18 % had entirely lost their job. Every second patient reported financial disadvantages.

CONCLUSIONS: The questionnaire yielded detailed information about the quality of outpatient care after discharge and confirmed the high socioeconomic burden among patients at two years after severe multiple injury.

CLINICAL REHABILITATION IMPACT: Long- term impairments after severe trauma are described frequently. Evaluation of ambulant treatment is the first step to optimize long- term rehabilitation and re-integration.